# PHILLIP E MEEHAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1609809094
- **Gender:** Man
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | 0571 | SD | Yes |

## Other

- **Enumeration date:** 07/08/2006
- **Last updated:** 12/18/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0127834 | MEDICA | SD |
| 05 | — | 10025568900 | — | NE |
| 01 | — | 1609809094 | ARAZ/ AMERICA'S PPO | SD |
| 05 | — | 1821021304 | — | IA |
| 01 | — | 248340 | MIDLAND'S CHOICE | SD |
| 01 | — | 46L92ME | CC SYSTEMS/ BLUE PLUS | MN |
| 01 | — | 4992676 | BLUE CROSS | SD |
| 01 | — | 57105AT04 | WPS TRICARE | SD |
| 05 | — | 6827152 | — | SD |
| 01 | — | 9238709 | DAKOTACARE | SD |
| 01 | — | C83141041559 | PREFERRED ONE | SD |