Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 35-05-7052 | OH |
N | 207QA0505X | Family Doctor - Adult Medicine | 40029 | KY |
NPI | 1215901772 |
---|---|
Provider Name | Dr. Perry Meadows |
First Address | Louisville, KY 40202-2129 |
Second Address | Louisville, KY 40202-2129 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2006 |
Last Update Date | 10/10/2008 |