Basic Information
Provider Information
NPI: 1437573961
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MEADOWS
FirstName: DAVID
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1940 STONEGATE DR STE 130
Address2:  
City: VESTAVIA HLS
State: AL
PostalCode: 352422541
CountryCode: US
TelephoneNumber: 2059779876
FaxNumber: 2059779976
Practice Location
Address1: 1940 STONEGATE DR STE 130
Address2:  
City: VESTAVIA HLS
State: AL
PostalCode: 352422541
CountryCode: US
TelephoneNumber: 2059779876
FaxNumber: 2059779976
Other Information
ProviderEnumerationDate: 02/04/2014
LastUpdateDate: 08/17/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/17/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000X1-111200ALY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


Home