Provider Demographics
NPI:1356441919
Name:MEININGER, MARK J (DC)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:J
Last Name:MEININGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 HAMPTON RD
Mailing Address - Street 2:P.O. BOX 3369
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-6508
Mailing Address - Country:US
Mailing Address - Phone:770-957-7881
Mailing Address - Fax:770-957-6283
Practice Address - Street 1:550 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-6508
Practice Address - Country:US
Practice Address - Phone:770-957-7881
Practice Address - Fax:770-957-6283
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2010-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA2429111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAT92597Medicare UPIN