Healthcare Provider Details

I. General information

NPI: 1467008516
Provider Name (Legal Business Name): KATELYN MEEK DILLARD A.U.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2019
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BAPTIST DR STE 206
MADISON MS
39110-2011
US

IV. Provider business mailing address

350 N HUMPHREYS BLVD
MEMPHIS TN
38120-2177
US

V. Phone/Fax

Practice location:
  • Phone: 601-973-1583
  • Fax: 601-973-1609
Mailing address:
  • Phone: 901-226-4003
  • Fax: 901-227-8591

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1883
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1883
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberA-4739
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: