Provider Demographics
NPI:1356979249
Name:MEIS, DANIEL ROBERT (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:ROBERT
Last Name:MEIS
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 1:811 E PARRISH AVE
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-3258
Mailing Address - Country:US
Mailing Address - Phone:270-688-1228
Mailing Address - Fax:
Practice Address - Street 1:15243 GREENFIELD DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:AL
Practice Address - Zip Code:35613-2899
Practice Address - Country:US
Practice Address - Phone:256-771-0094
Practice Address - Fax:256-771-1662
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR5360207Q00000X
ALDO.2790207Q00000X
390200000X
TN5469207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program