Provider Demographics
NPI:1053364596
Name:MEIGHEN, A G (OD)
Entity type:Individual
Prefix:DR
First Name:A
Middle Name:G
Last Name:MEIGHEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3806 11TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35222-4209
Mailing Address - Country:US
Mailing Address - Phone:205-625-5544
Mailing Address - Fax:888-479-3684
Practice Address - Street 1:36321 STATE HIGHWAY 79 STE 4
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:AL
Practice Address - Zip Code:35049
Practice Address - Country:US
Practice Address - Phone:205-913-1887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS739TA212152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL58335Medicare ID - Type Unspecified
ALU20660Medicare UPIN