Provider Demographics
NPI:1396816658
Name:MEADOR, RICHARD SELLORS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:SELLORS
Last Name:MEADOR
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 849850
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36685-0849
Mailing Address - Country:US
Mailing Address - Phone:251-343-5004
Mailing Address - Fax:251-343-5136
Practice Address - Street 1:124A SOUTH UNIVERSITY BLVD.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608
Practice Address - Country:US
Practice Address - Phone:251-343-5004
Practice Address - Fax:251-343-5136
Is Sole Proprietor?:No
Enumeration Date:2006-11-10
Last Update Date:2009-12-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL29500207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL110731Medicaid
AL510-49205OtherBCBS
AL102I390137Medicare PIN