MEDICARE: GREGORY K MEEKIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	16979	MS

General Provider Information

NPI Number	:	1417986910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GREGORY K MEEKIN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 7237
Second Line	:
City	:	GULFPORT
State	:	MS
Zip	:	39506-7237
Country	:	US
Telephone Number	:	228-864-0828
Fax Number	:	228-864-0191

Provider Business Practice Location Address
First Line	:	1201 31ST AVE
Second Line	:
City	:	GULFPORT
State	:	MS
Zip	:	39501-1847
Country	:	US
Telephone Number	:	228-284-2177
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2006
Last Update Date	:	07/17/2019

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