Provider Demographics
NPI:1912952458
Name:MEEK, QUINTON (MD)
Entity Type:Individual
Prefix:
First Name:QUINTON
Middle Name:
Last Name:MEEK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 CRANES ROOST CT
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-3650
Mailing Address - Country:US
Mailing Address - Phone:270-765-2605
Mailing Address - Fax:270-766-1222
Practice Address - Street 1:65 OLD SPRINFIELD RD.
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:KY
Practice Address - Zip Code:40033
Practice Address - Country:US
Practice Address - Phone:270-692-2509
Practice Address - Fax:270-692-2592
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY288872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000352019OtherANTHEM
11304796OtherCAQH
KY30605018Medicaid
KY0358988Medicare ID - Type UnspecifiedMEDICARE
KYCC4776Medicare ID - Type UnspecifiedMEDICARE RR
KY30605018Medicaid
11304796OtherCAQH
KY0762220Medicare ID - Type UnspecifiedMEDICARE
KY000000352019OtherANTHEM
F66922Medicare UPIN
KY0763517Medicare ID - Type UnspecifiedMEDICARE
KY0974701Medicare ID - Type UnspecifiedMEDICARE
KY0690934Medicare ID - Type UnspecifiedMEDICARE
KY0358888Medicare ID - Type UnspecifiedMEDICARE
KY0762317Medicare ID - Type UnspecifiedMEDICARE
0358786Medicare ID - Type Unspecified