Healthcare Provider Details

I. General information

NPI: 1164387239
Provider Name (Legal Business Name): MEGHAN RADFORD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3014 FORT CAMPBELL BLVD
HOPKINSVILLE KY
42240-4904
US

IV. Provider business mailing address

128 WESTBROOKE CIR
PEMBROKE KY
42266
US

V. Phone/Fax

Practice location:
  • Phone: 270-632-6828
  • Fax:
Mailing address:
  • Phone: 270-498-8953
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number299535
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: