Provider Demographics
NPI:1942253794
Name:LESLEY A MEEKER MD INC
Entity Type:Organization
Organization Name:LESLEY A MEEKER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:A
Authorized Official - Last Name:MEEKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-293-5080
Mailing Address - Street 1:3080 ACKERMAN BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-3559
Mailing Address - Country:US
Mailing Address - Phone:937-293-5080
Mailing Address - Fax:937-293-8820
Practice Address - Street 1:3080 ACKERMAN BLVD
Practice Address - Street 2:STE 300
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-3559
Practice Address - Country:US
Practice Address - Phone:937-293-5080
Practice Address - Fax:937-293-8820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2878122Medicaid
OH2878122Medicaid