Provider Demographics
NPI:1619060332
Name:BILLYS, MEDA MCCARLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:MEDA
Middle Name:MCCARLEY
Last Name:BILLYS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEDA
Other - Middle Name:ELIZABETH
Other - Last Name:MCCARLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2434
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93279-2434
Mailing Address - Country:US
Mailing Address - Phone:559-625-1060
Mailing Address - Fax:559-622-9902
Practice Address - Street 1:128 N AKERS RD
Practice Address - Street 2:SUITE C
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5121
Practice Address - Country:US
Practice Address - Phone:559-625-1060
Practice Address - Fax:559-622-9902
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2016-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG65714207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G657140Medicare ID - Type Unspecified
CAC82004Medicare UPIN