Provider Demographics
NPI:1215414578
Name:MEISTER, EMILY (OD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:MEISTER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:154 ASHLEY CT
Mailing Address - Street 2:
Mailing Address - City:SPEEDWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37870-7980
Mailing Address - Country:US
Mailing Address - Phone:606-495-7342
Mailing Address - Fax:
Practice Address - Street 1:1431 E CUMBERLAND AVE
Practice Address - Street 2:
Practice Address - City:MIDDLESBORO
Practice Address - State:KY
Practice Address - Zip Code:40965-4096
Practice Address - Country:US
Practice Address - Phone:606-248-7772
Practice Address - Fax:606-248-0575
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2110DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist