Individual
WILLARD SCOTT MEADOWS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
704 HWY 70 E, DICKSON, TN 37055-2111
(615) 620-2320
(615) 620-2323
Mailing address
PO BOX 299, MANCHESTER, TN 37349-0299
(931) 728-5607
(931) 728-8354
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN106855
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN10816
TN
367500000X
Certified Registered Nurse Anesthetist
ARNP5193A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009944350
—
AL
01
—
01259592
AMERIGROUP TENNCARE NON-PAR - INTEGRATED
TN
05
—
1506321
—
TN
01
—
3161402
BC/BS NUMBER
TN
05
—
3631210
—
TN
01
—
4206153
BLUE CROSS/BLUE SHIELD OF TN - INTEGRATED
TN
05
—
74002510
—
KY
01
—
P00689532
RR MEDICARE
TN
Enumeration date
09/20/2005
Last updated
09/14/2010
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