Provider Demographics
NPI:1851585814
Name:MEEK, ROBIN (MD)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MEEK
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:BLUEGRASS FUNCTIONAL MEDICINE
Mailing Address - Street 2:841 CORPORATE DRIVE, SUITE 204
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-300-3007
Mailing Address - Fax:912-434-4931
Practice Address - Street 1:BLUEGRASS FUNCTIONAL MEDICINE
Practice Address - Street 2:841 CORPORATE DRIVE, SUITE 204
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-300-3007
Practice Address - Fax:912-434-4931
Is Sole Proprietor?:No
Enumeration Date:2007-09-04
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY25856207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64258569Medicaid
KY64258569Medicaid