Individual
BRENT JAY MEREDITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
MP 123 GLENN HWY, TOK, AK 99780
(907) 883-5855
Mailing address
PO BOX 39035, BELFAST, ME 04915-1232
(907) 452-8251
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
227536
AK
363A00000X
Physician Assistant
PA01436
TX
363A00000X
Physician Assistant
PADA1107
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217002901
—
TX
Enumeration date
04/10/2007
Last updated
04/09/2026
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