Doctor Name: | MR. RANDALL GENE MEADOR |
NPI Number: | 1326124504 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | ATC |
License Number: | |
Business Practice Address: | 3521 Monongahela Blvd Coliseum Room 34 Morgantown, WV - 265053021 |
Business Phone Number: | 3042932737 |
Business Fax Number: | 3042933366 |
Mailing Address: | 471 Meridan St, MORGANTOWN |
State: | WV |
Postal Code: | 265052220 |
Phone Number: | 3045989225 |
Fax Number: | 3042933366 |
NPI Enumeration Date: | 10/31/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |