Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | R3027 | AR |
NPI | 1013956325 |
---|---|
Provider Name | Samuel G. Meredith |
First Address | Marion, AR 72364-9045 |
Second Address | Marion, AR 72364-9045 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2006 |
Last Update Date | 14/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
101992001 | (05) | AR |
B02828 | (02) | AR |