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General NPI Number Information
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NPI Number | 1023388733
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Entity Type | Organization
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Legal Business Name | SHIRLEY J MEREDITH, MD, PLLC
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/11/2012
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Provider Practice Location Address
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Address Line | 4000 KRESGE WAY BAPTIST EAST WOUND CARE CENTER
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City | LOUISVILLE
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State | KY
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Zip | 40207-4605
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Country | US
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Telephone | 502-259-4470
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Fax | 502-259-4471
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Provider Business Mailing Address
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Address Line | 5400 HILLOCK LANE
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City | CRESTWOOD
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State | KY
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Zip | 40014
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Country | US
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Telephone | 229-444-4140
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Fax |
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Authorized Official
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Title or Position | DR/PHYSICIAN
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Name | SHIRLEY J MEREDITH
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Credential | MD
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Telephone | 229-444-4140
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 41773
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License Number State | KY
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