Healthcare Provider Details

I. General information

NPI: 1780764407
Provider Name (Legal Business Name): STEPHEN F MEYERS PSC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 ALEXANDRIA PIKE
FT THOMAS KY
41075-2561
US

IV. Provider business mailing address

1501 ALEXANDRIA PIKE
FT THOMAS KY
41075-2561
US

V. Phone/Fax

Practice location:
  • Phone: 859-781-3110
  • Fax: 859-781-3087
Mailing address:
  • Phone: 859-781-3110
  • Fax: 859-781-3087

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberKY17308
License Number StateKY

VIII. Authorized Official

Name: STEPHEN F MEYERS
Title or Position: PHYSICIAN PSC PRESIDENT
Credential: P
Phone: 859-781-3110