Individual
KENNETH R MEACHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 498-6583
(479) 498-6585
Mailing address
101 SKYLINE DR, RUSSELLVILLE, AR 72801-3363
(479) 498-6583
(479) 498-6585
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
C4297
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
106516001
—
AR
Enumeration date
05/24/2006
Last updated
05/28/2019
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