Provider Demographics
NPI:1588750681
Name:MEYER, JOHN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1536 STORY AVE
Mailing Address - Street 2:THE EYE CARE INSTITUTE BUILDING
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1738
Mailing Address - Country:US
Mailing Address - Phone:502-589-1500
Mailing Address - Fax:502-589-1556
Practice Address - Street 1:1536 STORY AVE
Practice Address - Street 2:THE EYE CARE INSTITUTE BUILDING
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1738
Practice Address - Country:US
Practice Address - Phone:502-589-1500
Practice Address - Fax:502-589-1556
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31573207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200041120Medicaid
KY64315732Medicaid
KY1340212Medicare ID - Type Unspecified
KYF77492Medicare UPIN
IN200041120Medicaid
0842700001Medicare NSC