Provider Demographics
NPI:1417125543
Name:MEIS, JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:MEIS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 OAK ST
Mailing Address - Street 2:WAKULLA COUNTY HEALTH DEPARTMENT
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-2085
Mailing Address - Country:US
Mailing Address - Phone:850-926-0400
Mailing Address - Fax:
Practice Address - Street 1:48 OAK ST
Practice Address - Street 2:WAKULLA COUNTY HEALTH DEPARTMENT
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2085
Practice Address - Country:US
Practice Address - Phone:850-926-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2012-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLHAD2122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL001061000Medicaid