Provider Demographics
NPI:1588837645
Name:MEYER, JACOB CONRAD (MD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:CONRAD
Last Name:MEYER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:600 PETER JEFFERSON PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8835
Mailing Address - Country:US
Mailing Address - Phone:434-978-2040
Mailing Address - Fax:434-978-2040
Practice Address - Street 1:600 PETER JEFFERSON PKWY
Practice Address - Street 2:SUITE 350
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8835
Practice Address - Country:US
Practice Address - Phone:434-978-2040
Practice Address - Fax:434-978-2040
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036129823207W00000X
VA0101255370207W00000X, 207WX0107X
MO2012008076207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology