Organization
MEADOWVIEW PHYSICIAN PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS SARA MILLER (PRESIDENT)
(615) 920-7514
Entity
Organization
Contact information
Practice address
991 MEDICAL PARK DR, SUITE 201, MAYSVILLE, KY 41056-8764
(606) 759-3585
(606) 759-0676
Mailing address
989 MEDICAL PARK DR, MAYSVILLE, KY 41056-8750
(606) 759-3585
(606) 759-0676
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100231150
—
KY
Enumeration date
12/13/2011
Last updated
01/22/2018
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