Provider Demographics
NPI:1962559377
Name:MEYER, JEFFREY CHARLES (DO)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:CHARLES
Last Name:MEYER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:211 NE 54TH ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64118-4390
Mailing Address - Country:US
Mailing Address - Phone:816-453-6777
Mailing Address - Fax:816-454-3601
Practice Address - Street 1:211 NE 54TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64118-4390
Practice Address - Country:US
Practice Address - Phone:816-453-6777
Practice Address - Fax:816-454-3601
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2014-04-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO20050257172084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO39306011OtherBLUE CROSS BLUE SHIELD
MOW20F483Medicare PIN