Provider Demographics
NPI:1649228800
Name:J O MEADOWS MD PA
Entity Type:Organization
Organization Name:J O MEADOWS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:O
Authorized Official - Last Name:MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-543-0600
Mailing Address - Street 1:560 RIVERSIDE DRIVE
Mailing Address - Street 2:STE B202
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801
Mailing Address - Country:US
Mailing Address - Phone:410-543-0600
Mailing Address - Fax:410-543-9480
Practice Address - Street 1:560 RIVERSIDE DRIVE
Practice Address - Street 2:STE B202
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801
Practice Address - Country:US
Practice Address - Phone:410-543-0600
Practice Address - Fax:410-543-9480
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-04
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD19822207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4356826OtherCIGNA
MDS343OtherFED BCBS & BLUECHOICE
VA6067310OtherVA MEDICAID
733205OtherNCPPO
MD319987OtherMAMSI UHC
DE0000051301OtherDEL MEDICAID
MD5932JOOtherBLUE SHIELD
MD4356826OtherCIGNA
VA6067310OtherVA MEDICAID