Healthcare Provider Details

I. General information

NPI: 1639790397
Provider Name (Legal Business Name): GILBERT AUSTIN MEADOWS DMD, MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2020
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3640 CONFETTI BLUSH DR
COLUMBUS GA
31909-5719
US

IV. Provider business mailing address

3640 CONFETTI BLUSH DR
COLUMBUS GA
31909-5719
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-4507
  • Fax:
Mailing address:
  • Phone: 334-318-4527
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN124104
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: