Meacham, Kenneth R
Meacham, Kenneth R is an individual health care provider with primary practice located at 101 Skyline Dr , Russellville AR 72801-3363. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Meacham, Kenneth R can be contacted via phone (479) 498-6583.Contact Information
Primary practice address
101 Skyline Dr
Russellville AR 72801-3363
Phone: (479) 498-6583
Fax: (479) 498-6585
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | C4297 | Arkansas |
Profile Details
| NPI number | 1407801707 |
|---|---|
| LBN Legal business name | Meacham, Kenneth R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 24th, 2006 |
| Last updated | May 28th, 2019 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407801707 | NPPES |
| Arkansas | MEDICAID | 106516001 |
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