Organization
MEADE MEDICAL CLINIC SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A MEADE MD (PRESIDENT)
(920) 261-6500
Entity
Organization
Contact information
Practice address
134 HOSPITAL DR, WATERTOWN, WI 53098-3304
(920) 261-6500
(920) 261-6693
Mailing address
134 HOSPITAL DRIVE, WATERTOWN, WI 53098
(920) 261-6500
(920) 261-6693
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32875700
—
WI
Enumeration date
11/14/2006
Last updated
10/29/2011
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