Healthcare Provider Details

I. General information

NPI: 1467458745
Provider Name (Legal Business Name): KEVIN C MEYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 GRAND AVE
NEWPORT KY
41071-2570
US

IV. Provider business mailing address

PO BOX 635283
CINCINNATI OH
45263-5283
US

V. Phone/Fax

Practice location:
  • Phone: 859-905-3070
  • Fax: 859-441-1348
Mailing address:
  • Phone: 859-905-3070
  • Fax: 859-441-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35078105
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number01075760A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number48540
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: