Individual
MR. JEFFREY W MEINCKE-REZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
835 PARKSIDE ST, RIPON, WI 54971-8505
(920) 745-3500
(920) 745-7930
Mailing address
835 PARKSIDE ST, RIPON, WI 54971-8505
(920) 745-3500
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
41012
WI
207X00000X
Orthopaedic Surgery Physician
K6887
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0036JT
BLUE CROSS BLUE SHIELD
TX
05
—
045592503
—
TX
05
—
200039200A
—
OK
01
—
3000
NEIC
TX
01
—
3101855
AETNA
TX
01
—
P00007908
RAILROAD MEDICARE
TX
Enumeration date
03/30/2006
Last updated
03/07/2023
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