Provider Demographics
NPI:1831387448
Name:MEACHUM, FLOYD ANTHONY (DO)
Entity type:Individual
Prefix:
First Name:FLOYD
Middle Name:ANTHONY
Last Name:MEACHUM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1802 N CARSON ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-1265
Mailing Address - Country:US
Mailing Address - Phone:775-888-6610
Mailing Address - Fax:775-888-6610
Practice Address - Street 1:3900 CAMBRIDGE ST
Practice Address - Street 2:SUITE 102
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-7439
Practice Address - Country:US
Practice Address - Phone:702-307-5415
Practice Address - Fax:702-307-5416
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2012-04-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NVDO1609207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1831387448Medicaid
NV1831387448Medicaid