Provider Demographics
NPI:1689985202
Name:MEIER, MOLLY JO (DPM)
Entity Type:Individual
Prefix:
First Name:MOLLY
Middle Name:JO
Last Name:MEIER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1808 W BELTLINE HWY
Mailing Address - Street 2:ATTN: NANCY PIERCE-SSM HEALTH FDL REGIONAL CLINIC
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53713-2334
Mailing Address - Country:US
Mailing Address - Phone:920-926-8282
Mailing Address - Fax:
Practice Address - Street 1:790 EASTGATE DR
Practice Address - Street 2:
Practice Address - City:RIPON
Practice Address - State:WI
Practice Address - Zip Code:54971-9614
Practice Address - Country:US
Practice Address - Phone:920-926-8282
Practice Address - Fax:920-926-8098
Is Sole Proprietor?:No
Enumeration Date:2010-06-29
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1021-25213E00000X, 213ES0103X
KY00459213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist