Provider Demographics
NPI:1619683737
Name:FLATT, MEREDITH TILLMAN (OD)
Entity Type:Individual
Prefix:DR
First Name:MEREDITH
Middle Name:TILLMAN
Last Name:FLATT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:MEREDITH
Other - Middle Name:TILLMAN
Other - Last Name:FLATT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:PO BOX 1517
Mailing Address - Street 2:
Mailing Address - City:ANDALUSIA
Mailing Address - State:AL
Mailing Address - Zip Code:36420-1226
Mailing Address - Country:US
Mailing Address - Phone:334-222-2020
Mailing Address - Fax:334-222-6506
Practice Address - Street 1:1860 E THREE NOTCH ST
Practice Address - Street 2:
Practice Address - City:ANDALUSIA
Practice Address - State:AL
Practice Address - Zip Code:36421-2404
Practice Address - Country:US
Practice Address - Phone:334-222-2020
Practice Address - Fax:334-222-6506
Is Sole Proprietor?:No
Enumeration Date:2023-01-24
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALR-330152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist