MEDICARE: KEVIN DAVID MEAKIN DO

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
1	207K00000X	Allergy & Immunology Physician	DR.0016815	CO
2	207Y00000X	Otolaryngology Physician	0102201092	VA
3	207YX0905X	Otolaryngology/Facial Plastic Surgery Physician	0102201092	VA
4	207YX0007X	Plastic Surgery within the Head & Neck (Otolaryngology) Physician	DR.0016815	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DR0016815	OTHER	CO	COLORADO MEDICAL BOARD

General Provider Information

NPI Number	:	1730145418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN DAVID MEAKIN DO

Provider Business Mailing Address
First Line	:	PO BOX 7068
Second Line	:
City	:	PORTSMOUTH
State	:	VA
Zip	:	23707-0068
Country	:	US
Telephone Number	:	757-686-3508
Fax Number	:	757-686-0541

Provider Business Practice Location Address
First Line	:	1625 MEDICAL CENTER PT STE 190
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8721
Country	:	US
Telephone Number	:	719-345-1047
Fax Number	:	877-647-0202

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2006
Last Update Date	:	03/06/2024

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Directions to “ KEVIN DAVID MEAKIN DO” Practice Location

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