Provider Demographics
NPI:1336125285
Name:MEEKINS, MARCUS E (MD)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:E
Last Name:MEEKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:810 W FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:TN
Mailing Address - Zip Code:38301-3942
Mailing Address - Country:US
Mailing Address - Phone:731-668-1853
Mailing Address - Fax:731-664-7731
Practice Address - Street 1:810 W FOREST AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:TN
Practice Address - Zip Code:38301-3942
Practice Address - Country:US
Practice Address - Phone:731-668-1853
Practice Address - Fax:731-664-7731
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV10978207L00000X
CAA98953207L00000X
TN43477207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A989530Medicaid
NV100505801Medicaid
NV100505801Medicaid
NVI03370Medicare UPIN
CA00A989530Medicaid