Basic Information
| Provider Information | |||||||||
| NPI: | 1902579816 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MEADOWS | ||||||||
| FirstName: | PHILLIP | ||||||||
| MiddleName: | TAYLOR | ||||||||
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| Credential: | FNP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 134 ALEX CT | ||||||||
| Address2: | |||||||||
| City: | CALHOUN | ||||||||
| State: | GA | ||||||||
| PostalCode: | 307014843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7062639504 | ||||||||
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| Practice Location | |||||||||
| Address1: | 304 TURNER MCCALL BLVD SW | ||||||||
| Address2: | |||||||||
| City: | ROME | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301655621 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7065096110 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/27/2021 | ||||||||
| LastUpdateDate: | 07/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RN251144 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.