Healthcare Provider Details

I. General information

NPI: 1750310637
Provider Name (Legal Business Name): STARLA K MEIGS OD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 N CONGRESS BLVD
SMITHVILLE TN
37166-1445
US

IV. Provider business mailing address

107 N CONGRESS BLVD
SMITHVILLE TN
37166-1445
US

V. Phone/Fax

Practice location:
  • Phone: 615-597-4218
  • Fax: 615-597-4439
Mailing address:
  • Phone: 615-597-4218
  • Fax: 615-597-4439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1730
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: