Basic Information
| Provider Information | |||||||||
| NPI: | 1215414578 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEISTER | ||||||||
| FirstName: | EMILY | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 154 ASHLEY CT | ||||||||
| Address2: | |||||||||
| City: | SPEEDWELL | ||||||||
| State: | TN | ||||||||
| PostalCode: | 378707980 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6064957342 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1431 E CUMBERLAND AVE | ||||||||
| Address2: | |||||||||
| City: | MIDDLESBORO | ||||||||
| State: | KY | ||||||||
| PostalCode: | 409654096 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6062487772 | ||||||||
| FaxNumber: | 6062480575 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/19/2018 | ||||||||
| LastUpdateDate: | 10/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 2110DT | KY | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.