Provider Demographics
NPI:1134239106
Name:MEIGHAN, DENNIS MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:MEIGHAN
Suffix:
Gender:M
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:PO BOX 26067
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84126-0067
Mailing Address - Country:US
Mailing Address - Phone:239-624-0400
Mailing Address - Fax:239-624-0401
Practice Address - Street 1:350 7TH ST N
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5754
Practice Address - Country:US
Practice Address - Phone:239-624-2730
Practice Address - Fax:239-624-2731
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOS15476207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL73QJ3OtherBCBS
FL101754700Medicaid
CT040000196CT04OtherANTHEM BC & BS
CT100000448Medicare ID - Type Unspecified
CT000196Medicare UPIN