Provider Demographics
NPI:1922396894
Name:MEOUCHY, JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:MEOUCHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N EMPORIA ST STE 310
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67214-3727
Mailing Address - Country:US
Mailing Address - Phone:316-263-5891
Mailing Address - Fax:316-263-3083
Practice Address - Street 1:818 N EMPORIA ST STE 310
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3727
Practice Address - Country:US
Practice Address - Phone:316-263-5891
Practice Address - Fax:316-263-3083
Is Sole Proprietor?:No
Enumeration Date:2011-07-13
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-40337207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201166700AMedicaid