Provider Demographics
NPI:1861651580
Name:MEUNIOT, VANESSA LYDIA (DO)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:LYDIA
Last Name:MEUNIOT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 E CLARK BASS BLVD STE 301B
Mailing Address - Street 2:
Mailing Address - City:MCALESTER
Mailing Address - State:OK
Mailing Address - Zip Code:74501-4284
Mailing Address - Country:US
Mailing Address - Phone:918-421-6795
Mailing Address - Fax:
Practice Address - Street 1:4 E CLARK BASS BLVD STE 301B
Practice Address - Street 2:
Practice Address - City:MCALESTER
Practice Address - State:OK
Practice Address - Zip Code:74501-4284
Practice Address - Country:US
Practice Address - Phone:918-421-6795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-06
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A10927207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine