Individual
JEFFREY G. MECKLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
21 BELMONT AVE, BRATTLEBORO, VT 05301-7110
(802) 258-3905
(802) 258-4903
Mailing address
17 BELMONT AVE, SUITE 190, BRATTLEBORO, VT 05301-3498
(802) 257-8360
(802) 251-8435
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
007856
NY
363A00000X
Physician Assistant
Primary
055-0031105
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00007856
—
NY
05
—
02347597
—
NY
05
—
03046421
—
NY
05
—
9000529
—
VT
Enumeration date
02/24/2006
Last updated
04/13/2016
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