Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD011197 | TN |
NPI | 1164598876 |
---|---|
Provider Name | Patrick W Meacham |
First Address | Hendersonville, TN 37075 |
Second Address | Hendersonville, TN 37075 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A96712 | (02) |