Provider Demographics
NPI:1760773683
Name:RIDDLE, MEGHAN CLAYE (MD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:CLAYE
Last Name:RIDDLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 FOUNTAIN CT
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-1888
Mailing Address - Country:US
Mailing Address - Phone:859-323-6021
Mailing Address - Fax:
Practice Address - Street 1:345 BLACKSTONE BLV
Practice Address - Street 2:PSYCHIATRY
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-0290
Practice Address - Country:US
Practice Address - Phone:401-455-6200
Practice Address - Fax:401-455-6689
Is Sole Proprietor?:No
Enumeration Date:2011-04-26
Last Update Date:2021-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN527592084P0800X
KYTP6732084P0805X
RIMD177282084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry