Provider Demographics
NPI:1720696875
Name:GROVES, MEAGAN S (HIS)
Entity type:Individual
Prefix:
First Name:MEAGAN
Middle Name:S
Last Name:GROVES
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6783 VETERANS PKWY BLDG 4300
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3254
Mailing Address - Country:US
Mailing Address - Phone:706-576-9888
Mailing Address - Fax:
Practice Address - Street 1:6783 VETERANS PKWY BLDG 4300
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3254
Practice Address - Country:US
Practice Address - Phone:706-576-9888
Practice Address - Fax:678-802-0542
Is Sole Proprietor?:No
Enumeration Date:2020-07-15
Last Update Date:2020-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAHAA-000158237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist