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Individual

JOHN D MESKO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
403 NORTH MORROW, SUITE A, MENA, AR 71953
(479) 394-4595
(479) 394-1140
Mailing address
403 NORTH MORROW, SUITE A, MENA, AR 71953
(479) 394-4595
(479) 394-1140

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C6220
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100071960 A
OK
05
112972001
AR
01
50764
BLUE CROSS BLUE SHEILD
AR
01
710709244
TAX ID #
AR
Enumeration date
07/31/2006
Last updated
11/12/2010
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