Provider Demographics
NPI:1255102729
Name:MELOYMED DIRECT HEALTH, PLLC
Entity type:Organization
Organization Name:MELOYMED DIRECT HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:MELOY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:321-482-8432
Mailing Address - Street 1:6803 W SOUTHGATE ESTATES CT
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-4271
Mailing Address - Country:US
Mailing Address - Phone:918-625-5403
Mailing Address - Fax:
Practice Address - Street 1:6803 W SOUTHGATE ESTATES CT
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-4271
Practice Address - Country:US
Practice Address - Phone:321-482-8432
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty