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NPI Code Detail

MEDICARE: FIRST INTERMED CORPORATION

MEDICARE: FIRST INTERMED CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMS

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CH7891OTHERMSRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1275567281
Entity Type Code : Organization
Provider Name (Legal Business Name) : FIRST INTERMED CORPORATION
Provider Business Mailing Address
First Line : 7300 S SIWELL RD
Second Line :
City : BYRAM
State : MS
Zip : 39272-9772
Country : US
Telephone Number : 601-373-1234
Fax Number : 601-373-1397
Provider Business Practice Location Address
First Line : 7300 S SIWELL RD
Second Line :
City : BYRAM
State : MS
Zip : 39272-9772
Country : US
Telephone Number : 601-373-1234
Fax Number : 601-373-1397
Authorized Official
Title or Position : CFO
Name : SAM SCOTT
Credential :
Telephone Number : 601-898-7525
Provider Enumeration Date : 07/10/2006
Last Update Date : 02/12/2008

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Directions to “FIRST INTERMED CORPORATION ” Practice Location

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