Provider Demographics
NPI:1427212091
Name:MEIER, JEFFREY D (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:D
Last Name:MEIER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2050 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2035
Mailing Address - Country:US
Mailing Address - Phone:219-661-0196
Mailing Address - Fax:219-661-1593
Practice Address - Street 1:757 45TH AVE
Practice Address - Street 2:STE. 201
Practice Address - City:MUNSTER
Practice Address - State:IN
Practice Address - Zip Code:46321-2911
Practice Address - Country:US
Practice Address - Phone:219-934-2461
Practice Address - Fax:219-934-2478
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.138643207X00000X
CA20A10335174400000X, 207X00000X
IN02003718A207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Single Specialty