Provider Demographics
NPI:1346454154
Name:MEADOWS, ROCKFORD JAMES (MD)
Entity Type:Individual
Prefix:
First Name:ROCKFORD
Middle Name:JAMES
Last Name:MEADOWS
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 1:1735 27TH ST STE B06
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-2681
Mailing Address - Country:US
Mailing Address - Phone:740-356-8681
Mailing Address - Fax:740-353-7900
Practice Address - Street 1:1005 E RING RD
Practice Address - Street 2:
Practice Address - City:IRONTON
Practice Address - State:OH
Practice Address - Zip Code:45638-9610
Practice Address - Country:US
Practice Address - Phone:740-534-9830
Practice Address - Fax:740-534-9832
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.092454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000593194OtherANTHEM BCBS
OH2865805Medicaid
KY000000585221OtherANTHEM BCBS
KY000000609822OtherANTHEM BCBS
KY7100055940Medicaid
KYP00673293OtherRR MEDICARE
OH4252711Medicare PIN
KY3400072Medicare PIN
KYP00712836Medicare PIN
KY000000609822OtherANTHEM BCBS
KY00749003Medicare PIN