Provider Demographics
NPI:1275732596
Name:MEADOWS, BERNARD J JR (DPM)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:J
Last Name:MEADOWS
Suffix:JR
Gender:M
Credentials:DPM
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Mailing Address - Street 1:6300 E LAKE BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:VANCLEAVE
Mailing Address - State:MS
Mailing Address - Zip Code:39565-6770
Mailing Address - Country:US
Mailing Address - Phone:228-230-2663
Mailing Address - Fax:228-206-1192
Practice Address - Street 1:1720A MEDICAL PARK DR STE 220
Practice Address - Street 2:
Practice Address - City:BILOXI
Practice Address - State:MS
Practice Address - Zip Code:39532-2127
Practice Address - Country:US
Practice Address - Phone:228-392-9355
Practice Address - Fax:228-392-1781
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2017-03-22
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Provider Licenses
StateLicense IDTaxonomies
MS80204213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery