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General NPI Number Information
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NPI Number | 1912919929
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Entity Type | Organization
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Legal Business Name | MEADE PHYSICIANS, INC.
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 815 HILLCREST DR
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City | BRANDENBURG
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State | KY
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Zip | 40108-1415
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Country | US
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Telephone | 270-422-4111
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Fax |
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Provider Business Mailing Address
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Address Line | 815 HILLCREST DR
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City | BRANDENBURG
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State | KY
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Zip | 40108-1415
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Country | US
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Telephone | 270-422-4111
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. CRYSTAL DAWN WEBSTER
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Credential |
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Telephone | 270-422-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3003595
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | KY
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