Provider Demographics
NPI:1588044689
Name:MEUSSNER, JEFFREY II
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:
Last Name:MEUSSNER
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17205 JESSICA DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-6421
Mailing Address - Country:US
Mailing Address - Phone:734-558-0637
Mailing Address - Fax:
Practice Address - Street 1:17205 JESSICA DR
Practice Address - Street 2:
Practice Address - City:SOUTHGATE
Practice Address - State:MI
Practice Address - Zip Code:48195-6421
Practice Address - Country:US
Practice Address - Phone:734-558-0637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIM256390887349247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other