Individual
JANET SUE MECKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
535 W EATON PIKE, STATE LINE FAMILY MEDICINE, RICHMOND, IN 47374-2641
(765) 935-8862
(765) 935-8863
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 935-8862
(765) 935-8863
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041137
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000938984
ANTHEM
IN
05
—
100389350
—
IN
Enumeration date
03/28/2006
Last updated
05/17/2021
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