Provider Demographics
NPI:1568576049
Name:MEEKS, RUDY WAYNE (DDS)
Entity Type:Individual
Prefix:
First Name:RUDY
Middle Name:WAYNE
Last Name:MEEKS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:PARSONS
Mailing Address - State:TN
Mailing Address - Zip Code:38363-0427
Mailing Address - Country:US
Mailing Address - Phone:731-847-2524
Mailing Address - Fax:731-847-6482
Practice Address - Street 1:519 FLORIDA AVE N
Practice Address - Street 2:
Practice Address - City:PARSONS
Practice Address - State:TN
Practice Address - Zip Code:38363-2627
Practice Address - Country:US
Practice Address - Phone:731-847-2524
Practice Address - Fax:731-847-6482
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000032311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice