Healthcare Provider Details

I. General information

NPI: 1417448408
Provider Name (Legal Business Name): THOMAS MICHAEL MEIRICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2018
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6200 WESTOWN PKWY
WEST DES MOINES IA
50266-7755
US

IV. Provider business mailing address

6200 WESTOWN PKWY
WEST DES MOINES IA
50266-7755
US

V. Phone/Fax

Practice location:
  • Phone: 800-542-7956
  • Fax: 515-223-5468
Mailing address:
  • Phone: 800-542-7956
  • Fax: 515-223-5468

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number71588
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number51349
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: