Provider Demographics
NPI:1700170602
Name:MEADOWS, K BRENT (DO)
Entity Type:Individual
Prefix:
First Name:K
Middle Name:BRENT
Last Name:MEADOWS
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 1:725 GLENWOOD DR STE E788
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1177
Mailing Address - Country:US
Mailing Address - Phone:423-495-3940
Mailing Address - Fax:423-495-3949
Practice Address - Street 1:725 GLENWOOD DR STE E788
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1177
Practice Address - Country:US
Practice Address - Phone:423-495-3940
Practice Address - Fax:423-495-3949
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2562207Q00000X
NC172682207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine