Basic Information
| Provider Information | |||||||||
| NPI: | 1780617514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MEEKS | ||||||||
| FirstName: | TONI | ||||||||
| MiddleName: | D | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1843 QUIET CV | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283043857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104838080 | ||||||||
| FaxNumber: | 9104833258 | ||||||||
| Practice Location | |||||||||
| Address1: | 1843 QUIET CV | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283043857 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9104838080 | ||||||||
| FaxNumber: | 9104833258 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 03/02/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 00-36774 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 8958441 | 05 | NC | MEDICAID |