Provider Demographics
NPI:1003860545
Name:MEZA, STERLING A (MD)
Entity Type:Individual
Prefix:MR
First Name:STERLING
Middle Name:A
Last Name:MEZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7479 HIGHWAY 762
Mailing Address - Street 2:
Mailing Address - City:PHILPOT
Mailing Address - State:KY
Mailing Address - Zip Code:42366-9330
Mailing Address - Country:US
Mailing Address - Phone:270-684-5005
Mailing Address - Fax:270-926-4432
Practice Address - Street 1:815 E PARRISH AVE
Practice Address - Street 2:SUITE 460
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3222
Practice Address - Country:US
Practice Address - Phone:270-684-5005
Practice Address - Fax:270-926-4432
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY38019207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64063753Medicaid
KY0980703Medicare ID - Type Unspecified
KY64063753Medicaid