Provider Demographics
NPI:1124030549
Name:MEAKER, PHILIP SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:SCOTT
Last Name:MEAKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6532 ANTHONY DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:VICTOR
Mailing Address - State:NY
Mailing Address - Zip Code:14564-1403
Mailing Address - Country:US
Mailing Address - Phone:585-924-2100
Mailing Address - Fax:585-924-5920
Practice Address - Street 1:6532 ANTHONY DR STE A
Practice Address - Street 2:
Practice Address - City:VICTOR
Practice Address - State:NY
Practice Address - Zip Code:14564-1422
Practice Address - Country:US
Practice Address - Phone:585-924-2100
Practice Address - Fax:585-398-1217
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242284208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics