Provider Demographics
NPI:1427006436
Name:MEADE, ROBERT LAWTON JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LAWTON
Last Name:MEADE
Suffix:JR
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:PO BOX 746638
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6638
Mailing Address - Country:US
Mailing Address - Phone:904-202-2092
Mailing Address - Fax:904-376-4075
Practice Address - Street 1:3690 SAINT JOHNS BLUFF RD S
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32224-2616
Practice Address - Country:US
Practice Address - Phone:904-564-4343
Practice Address - Fax:904-390-7443
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2013-00725207Q00000X, 207Q00000X
FLME48853207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL14194OtherBCBS
GA329964944AMedicaid
FL372067500Medicaid
NCP01447966OtherRAILROAD MEDICARE
NCNCM488A194OtherMEDICARE PTAN
FL14194OtherBCBS
GA329964944AMedicaid
FLP00348318Medicare PIN