Provider Demographics
NPI:1427639251
Name:MEUTH, JOSEPH TAYLOR (BSW)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:TAYLOR
Last Name:MEUTH
Suffix:
Gender:M
Credentials:BSW
Other - Prefix:MR
Other - First Name:JOSEPH
Other - Middle Name:TAYLOR
Other - Last Name:MEUTH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:BSW
Mailing Address - Street 1:1100 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42301-2956
Mailing Address - Country:US
Mailing Address - Phone:270-689-6500
Mailing Address - Fax:
Practice Address - Street 1:1100 WALNUT ST
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42301-2956
Practice Address - Country:US
Practice Address - Phone:270-689-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
010585
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY010585Medicaid