Basic Information
Provider Information
NPI: 1437106408
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEFFORD
FirstName: JOSEPH
MiddleName: B
NamePrefix:  
NameSuffix:  
Credential: PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 950243
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402950243
CountryCode: US
TelephoneNumber: 5022382801
FaxNumber: 5022382835
Practice Location
Address1: 1051-H NEWTOWN PIKE
Address2:  
City: LEXINGTON
State: KY
PostalCode: 40511
CountryCode: US
TelephoneNumber: 8592530076
FaxNumber: 8592530890
Other Information
ProviderEnumerationDate: 05/27/2006
LastUpdateDate: 02/17/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XKY004561KYY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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