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NPI Code Detail

MEDICARE: PHILLIP MEREDITH O.D.

MEDICARE: PHILLIP MEREDITH O.D.
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
1152W00000XOptometrist1028SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740256841
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP MEREDITH O.D.
Provider Business Mailing Address
First Line : 1651 GLENNS BAY RD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29575-4836
Country : US
Telephone Number : 843-650-2400
Fax Number : 843-699-2227
Provider Business Practice Location Address
First Line : 1651 GLENNS BAY RD
Second Line :
City : MYRTLE BEACH
State : SC
Zip : 29575-4836
Country : US
Telephone Number : 843-650-2400
Fax Number : 843-699-2227
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2006
Last Update Date : 09/18/2024

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