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General NPI Number Information
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NPI Number | 1366005308
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Entity Type | Individual
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Provider Name | BENJAMIN RANDAL MEIS DO
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Gender | Male
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 6800 HARRISON PARK DR
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City | HARRISON
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State | TN
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Zip | 37341-9621
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Country | US
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Telephone | 233-447-0954
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Fax | 423-344-7569
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Provider Business Mailing Address
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Address Line | 1301 PRIMACY PKWY
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City | MEMPHIS
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State | TN
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Zip | 38119-0213
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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 |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4376
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License Number State | TN
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