Provider Demographics
NPI:1710018577
Name:JAMES E. MEEHAN O.D.
Entity Type:Organization
Organization Name:JAMES E. MEEHAN O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEEHAN
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:724-548-5146
Mailing Address - Street 1:249 ARCH ST
Mailing Address - Street 2:P.O. BOX 878
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201-1577
Mailing Address - Country:US
Mailing Address - Phone:724-548-5146
Mailing Address - Fax:724-545-2117
Practice Address - Street 1:249 ARCH ST
Practice Address - Street 2:
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-1577
Practice Address - Country:US
Practice Address - Phone:724-548-5146
Practice Address - Fax:724-545-2117
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332H00000XSuppliersEyewear Supplier
No152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA630209Medicare ID - Type Unspecified
PA0558520001Medicare NSC