Healthcare Provider Details

I. General information

NPI: 1366496077
Provider Name (Legal Business Name): SHERRY MORGAN MEADOWS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 12/27/2021
Certification Date: 12/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12701 PADGETT SWITCH RD
IRVINGTON AL
36544-4011
US

IV. Provider business mailing address

PO BOX 769
BAYOU LA BATRE AL
36509
US

V. Phone/Fax

Practice location:
  • Phone: 251-824-2174
  • Fax: 251-824-3444
Mailing address:
  • Phone: 251-824-2174
  • Fax: 314-317-0606

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number00021276
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number21276
License Number StateAL
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number21276
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: