Individual
DR. ROBERT J MEADOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 TRUMANSBURG ROAD, SUITE R, ITHACA, NY 14850-5738
(607) 277-2710
(607) 257-2923
Mailing address
1301 TRUMANSBURG RD, SUITE R, ITHACA, NY 14850-1397
(607) 277-2710
(607) 257-2923
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
K5626
TX
207RR0500X
Rheumatology Physician
Primary
K5626
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
152193201
—
TX
05
—
204356115
—
NY
01
—
660003815
RR MEDICARE
TN
Enumeration date
07/03/2006
Last updated
10/28/2016
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