Provider Demographics
NPI:1801811559
Name:JEFFREY VAN METER MD INC
Entity type:Organization
Organization Name:JEFFREY VAN METER MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:VAN METER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-743-2464
Mailing Address - Street 1:PO BOX 1821
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43702-1821
Mailing Address - Country:US
Mailing Address - Phone:740-455-9788
Mailing Address - Fax:740-455-3686
Practice Address - Street 1:400 S COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:OH
Practice Address - Zip Code:43783-9750
Practice Address - Country:US
Practice Address - Phone:740-743-2464
Practice Address - Fax:740-743-2346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35069196OtherOHIO LICENSE NUMBER
OH2041614Medicaid
OH2041614Medicaid
OH9362271Medicare PIN