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NPI Code Detail

MEDICARE: MR. LEE G MEYER

MEDICARE: MR. LEE G MEYER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1237700000XHearing Instrument Specialist2625MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12625OTHERMNMN HEARING INSTRUMENT SPECIALIST

General Provider Information

NPI Number : 1407982820
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. LEE G MEYER
Provider Business Mailing Address
First Line : 1305 1ST ST S
Second Line : SUITE 1
City : WILLMAR
State : MN
Zip : 56201-4236
Country : US
Telephone Number : 320-214-7737
Fax Number : 320-235-0797
Provider Business Practice Location Address
First Line : 1305 1ST ST S
Second Line : SUITE 1
City : WILLMAR
State : MN
Zip : 56201-4236
Country : US
Telephone Number : 320-214-7737
Fax Number : 320-235-0797
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2007
Last Update Date : 02/18/2009

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