MEDICARE: MR. BRIAN PHILIP MEIER CRNA

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	367500000X	Certified Registered Nurse Anesthetist	C002975	AR

General Provider Information

NPI Number	:	1790122810
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN PHILIP MEIER CRNA

Provider Business Mailing Address
First Line	:	3424 WESTERN GALES
Second Line	:
City	:	JONESBORO
State	:	AR
Zip	:	72401
Country	:	US
Telephone Number	:	870-819-1750
Fax Number	:	501-227-0744

Provider Business Practice Location Address
First Line	:	2024 ARKANSAS VALLEY DR
Second Line	:	#202
City	:	LITTLE ROCK
State	:	AR
Zip	:	72212-4166
Country	:	US
Telephone Number	:	501-227-0700
Fax Number	:	501-227-0744

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

Provider Enumeration Date	:	05/30/2013
Last Update Date	:	05/30/2013

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