Jeremy Meisel Md Llc | |
4904 Timber Ridge Dr Suite 305 Douglasville GA 30135-1828 | |
(678) 501-5420 | |
(678) 501-5429 |
Full Name | Jeremy Meisel Md Llc |
---|---|
Speciality | Psychiatry & Neurology |
Location | 4904 Timber Ridge Dr, Douglasville, Georgia |
Authorized Official Name and Position | Jeremy Meisel (OWNER) |
Authorized Official Contact | 6785015420 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Jeremy Meisel Md Llc 1579 Monroe Dr Ne Ste F Suite F602 Atlanta GA 30324-5022 Ph: (678) 501-5420 | Jeremy Meisel Md Llc 4904 Timber Ridge Dr Suite 305 Douglasville GA 30135-1828 Ph: (678) 501-5420 |
NPI Number | 1790118131 |
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Provider Enumeration Date | 08/20/2013 |
Last Update Date | 11/17/2014 |
Medicare PECOS PAC ID | 1658505276 |
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Medicare Enrollment ID | O20131014000938 |
Identifier | Type | State | Issuer |
---|---|---|---|
1790118131 | NPI | - | NPPES |
612935883D | Medicaid | GA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 052786 (Georgia) | Primary |
Provider Name | Jeremy N Meisel |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1679513865 PECOS PAC ID: 6204890817 Enrollment ID: I20041115000077 |
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