Healthcare Provider Details

I. General information

NPI: 1598983751
Provider Name (Legal Business Name): STEPHEN F MEYERS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 02/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 ALEXANDRIA PIKE
FORT THOMAS KY
41075-2561
US

IV. Provider business mailing address

1501 ALEXANDRIA PIKE
FORT THOMAS KY
41075-2561
US

V. Phone/Fax

Practice location:
  • Phone: 859-781-3110
  • Fax:
Mailing address:
  • Phone: 859-781-3110
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberK17308
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: