Provider Demographics
NPI:1659379477
Name:MEEK, BRADLEY LAMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:BRADLEY
Middle Name:LAMAR
Last Name:MEEK
Suffix:
Gender:M
Credentials:MD
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 84460
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70884-4460
Mailing Address - Country:US
Mailing Address - Phone:225-526-0011
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:8119 PICARDY AVE
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3515
Practice Address - Country:US
Practice Address - Phone:225-214-3638
Practice Address - Fax:225-214-3639
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA13038R207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA110234490OtherRAILROAD MEDICARE
LA1544294Medicaid
LA5E458D279Medicare PIN
LA110234490OtherRAILROAD MEDICARE
LAG71095Medicare UPIN