Individual
JACOB PAUL MEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4700
Mailing address
1630 COMMANCHE AVE, GREEN BAY, WI 54313-5753
(920) 430-4700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7355920
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2017
Last updated
10/18/2020
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