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General NPI Number Information
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NPI Number | 1164433678
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Entity Type | Organization
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Legal Business Name | MERIDIAN ONCOLOGY ASSOCIATES PLLC
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 09/11/2017
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Provider Practice Location Address
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Address Line | 1704 23RD AVE 2ND FLR
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City | MERIDIAN
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State | MS
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Zip | 39301-3103
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Country | US
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Telephone | 601-482-1555
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Fax | 601-696-4611
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Provider Business Mailing Address
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Address Line | 1704 23RD AVE 2ND FLR
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City | MERIDIAN
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State | MS
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Zip | 39301-3103
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | WENDY TURNER
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Credential |
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Telephone | 601-482-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number | 20329
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License Number State | MS
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