Provider Demographics
NPI:1831194760
Name:MEEKS, LEON S (MD)
Entity type:Individual
Prefix:
First Name:LEON
Middle Name:S
Last Name:MEEKS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3527 N VALDOSTA RD
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-1068
Mailing Address - Country:US
Mailing Address - Phone:229-247-2290
Mailing Address - Fax:229-244-2626
Practice Address - Street 1:3527 N VALDOSTA RD
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-1068
Practice Address - Country:US
Practice Address - Phone:229-247-2290
Practice Address - Fax:229-244-2626
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039868207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00653353AMedicaid
GA00653353AMedicaid
20BDCMKMedicare ID - Type Unspecified