Provider Demographics
NPI:1871649533
Name:WOMENS MEDICAL CENTER OF MERIDIAN
Entity type:Organization
Organization Name:WOMENS MEDICAL CENTER OF MERIDIAN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MCKIEVER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-483-0039
Mailing Address - Street 1:1523 22ND AVE
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301
Mailing Address - Country:US
Mailing Address - Phone:601-483-0039
Mailing Address - Fax:601-485-7240
Practice Address - Street 1:1523 22ND AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301
Practice Address - Country:US
Practice Address - Phone:601-483-0039
Practice Address - Fax:601-485-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-26
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00121929Medicaid
MS00111934Medicaid
MSE83796Medicare UPIN
MSH12197Medicare UPIN
MS160000608Medicare ID - Type Unspecified
MS00121929Medicaid