Healthcare Provider Details

I. General information

NPI: 1497104061
Provider Name (Legal Business Name): STACY MEEKS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2016
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66840 BELMONT MORRISTOWN RD
BELMONT OH
43718-9665
US

IV. Provider business mailing address

66840 BELMONT MORRISTOWN RD
BELMONT OH
43718-9665
US

V. Phone/Fax

Practice location:
  • Phone: 740-782-1031
  • Fax:
Mailing address:
  • Phone: 740-782-1031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.013990
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: