Provider Demographics
NPI:1326508565
Name:MELDAU, JASON EDWARD
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:EDWARD
Last Name:MELDAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9735 N 90TH PL
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-5067
Mailing Address - Country:US
Mailing Address - Phone:480-222-4954
Mailing Address - Fax:480-210-5460
Practice Address - Street 1:9735 N 90TH PL
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-5067
Practice Address - Country:US
Practice Address - Phone:480-222-4954
Practice Address - Fax:480-210-5460
Is Sole Proprietor?:No
Enumeration Date:2019-03-22
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.073690207X00000X
390200000X
AZ72415207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program