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General NPI Number Information
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NPI Number | 1124020722
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Entity Type | Individual
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Provider Name | MARIANNETTE J MILLER-MEEKS M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 02/02/2016
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Provider Practice Location Address
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Address Line | 1223 S GEAR AVE SUITE 309
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1682
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Country | US
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Telephone | 319-768-4500
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Fax | 319-768-4505
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Provider Business Mailing Address
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Address Line | 1223 S GEAR AVE SUITE 309
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City | WEST BURLINGTON
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State | IA
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Zip | 52655-1682
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Country | US
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Telephone | 319-768-4500
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Fax | 319-768-4505
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 26438
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License Number State | IA
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