Healthcare Provider Details

I. General information

NPI: 1659908689
Provider Name (Legal Business Name): JACOB MEECE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 01/14/2026
Certification Date: 01/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 E WALNUT ST
NICHOLASVILLE KY
40356-1252
US

IV. Provider business mailing address

210 E WALNUT ST
NICHOLASVILLE KY
40356-1252
US

V. Phone/Fax

Practice location:
  • Phone: 859-225-4325
  • Fax:
Mailing address:
  • Phone: 859-225-4325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number59668
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number59668
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: