Provider Demographics
NPI:1346552668
Name:MEIMAN, JONATHAN G (MD)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:G
Last Name:MEIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 KINSMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-2526
Mailing Address - Country:US
Mailing Address - Phone:608-210-5454
Mailing Address - Fax:
Practice Address - Street 1:3402 KINSMAN BLVD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2526
Practice Address - Country:US
Practice Address - Phone:866-429-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-02
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI56800-20207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine