Provider Demographics
NPI:1730145418
Name:MEAKIN, KEVIN DAVID (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:DAVID
Last Name:MEAKIN
Suffix:
Gender:M
Credentials:DO
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 7068
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-0068
Mailing Address - Country:US
Mailing Address - Phone:757-686-3508
Mailing Address - Fax:757-686-0541
Practice Address - Street 1:1625 MEDICAL CENTER PT STE 190
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-8721
Practice Address - Country:US
Practice Address - Phone:719-345-1047
Practice Address - Fax:877-647-0202
Is Sole Proprietor?:No
Enumeration Date:2006-04-22
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0016815207K00000X, 207YX0007X
VA0102201092207Y00000X, 207YX0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CODR0016815OtherCOLORADO MEDICAL BOARD
VA040014768OtherRAILROAD MEDICARE
NC89063C0Medicaid
NY02199168Medicaid
VA5841968Medicaid
NC89063C0Medicaid