Provider Demographics
NPI:1750310637
Name:MEIGS, STARLA K (OD)
Entity Type:Individual
Prefix:DR
First Name:STARLA
Middle Name:K
Last Name:MEIGS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N CONGRESS BLVD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37166-1445
Mailing Address - Country:US
Mailing Address - Phone:615-597-4218
Mailing Address - Fax:615-597-4439
Practice Address - Street 1:107 N CONGRESS BLVD
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37166-1445
Practice Address - Country:US
Practice Address - Phone:615-597-4218
Practice Address - Fax:615-597-4439
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1730152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3055077Medicaid
TN1186890001Medicare NSC
U65120Medicare UPIN
TNU65120Medicare UPIN
TN3940824Medicare ID - Type Unspecified