Healthcare Provider Details

I. General information

NPI: 1629003702
Provider Name (Legal Business Name): GEORGE RODNEY MEEKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 04/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

2500 N STATE ST
JACKSON MS
39216-4500
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-5373
  • Fax: 601-984-5476
Mailing address:
  • Phone: 601-984-5373
  • Fax: 601-984-5476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number7036
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: