Healthcare Provider Details

I. General information

NPI: 1881799773
Provider Name (Legal Business Name): MARTIN L. MEINIG M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 10/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 BIEHN STREET SUITE 1
KLAMATH FALLS OR
97601-1181
US

IV. Provider business mailing address

2640 BIEHN STREET SUITE 1
KLAMATH FALLS OR
97601-1181
US

V. Phone/Fax

Practice location:
  • Phone: 541-205-6890
  • Fax:
Mailing address:
  • Phone: 541-205-6890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0101233239
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMD27787
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: