Meleesa Geathers
Individual provider Active NPI Contractor · Phenix City, AL
NPI 1093371940 · NPPES record last updated May 16, 2019
Key facts
- NPI
- 1093371940
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- G362556767510 (FL)
- Practice address
- 8 Clayton CT
Phenix City, AL 36869-3462 - Phone
- (863) 473-2052
- NPI assigned
- May 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G362556767510 | FL | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | G362556767510 | FL | Yes |
Addresses
Primary practice location
8 Clayton CT
Phenix City, AL 36869-3462
Mailing address
8 Clayton CT
Phenix City, AL 36869-3462
Phone (863) 473-2052
Other providers in Phenix City, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 16, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.