MEDICARE: DR. MEREDITH TILLMAN FLATT OD

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	152W00000X	Optometrist	R-330	AL

General Provider Information

NPI Number	:	1619683737
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MEREDITH TILLMAN FLATT OD

Provider Business Mailing Address
First Line	:	PO BOX 1517
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36420-1226
Country	:	US
Telephone Number	:	334-222-2020
Fax Number	:	334-222-6506

Provider Business Practice Location Address
First Line	:	1860 E THREE NOTCH ST
Second Line	:
City	:	ANDALUSIA
State	:	AL
Zip	:	36421-2404
Country	:	US
Telephone Number	:	334-222-2020
Fax Number	:	334-222-6506

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

Provider Enumeration Date	:	01/24/2023
Last Update Date	:	01/31/2023

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Directions to “ DR. MEREDITH TILLMAN FLATT OD” Practice Location

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