Provider Demographics
NPI:1558560383
Name:ALVIN H. MEYER, JR., M.D., P.C.
Entity Type:Organization
Organization Name:ALVIN H. MEYER, JR., M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:H
Authorized Official - Last Name:MEYER
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:615-889-5171
Mailing Address - Street 1:5651 FRIST BLVD
Mailing Address - Street 2:STE 509
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-2054
Mailing Address - Country:US
Mailing Address - Phone:615-889-5171
Mailing Address - Fax:615-889-5172
Practice Address - Street 1:5651 FRIST BLVD
Practice Address - Street 2:STE 509
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-2054
Practice Address - Country:US
Practice Address - Phone:615-889-5171
Practice Address - Fax:615-889-5172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD8174207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
3154562Medicare Oscar/Certification
D70136Medicare UPIN