Healthcare Provider Details

I. General information

NPI: 1396234605
Provider Name (Legal Business Name): TESS F MEKLIR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14231 BEADLE LAKE RD
BATTLE CREEK MI
49014-8213
US

IV. Provider business mailing address

7900 LEES SUMMIT RD
KANSAS CITY MO
64139-1236
US

V. Phone/Fax

Practice location:
  • Phone: 269-962-0441
  • Fax:
Mailing address:
  • Phone: 816-404-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number133482
License Number StateAK
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2021025256
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4301507671
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: