Healthcare Provider Details

I. General information

NPI: 1932838869
Provider Name (Legal Business Name): MORGAN ELIJAH MEADE PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 JOHNSTON MEMORIAL DR
ABINGDON VA
24211-7664
US

IV. Provider business mailing address

287 BARGER HOLLOW RD
BLOUNTVILLE TN
37617-3455
US

V. Phone/Fax

Practice location:
  • Phone: 276-258-1000
  • Fax:
Mailing address:
  • Phone: 276-275-1892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number5066
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number0110008763
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number5066
License Number StateTN
# 4
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110008763
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: