Provider Demographics
NPI:1447665880
Name:MEEUWSEN, JOSEPH JACOB (PA-C)
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JACOB
Last Name:MEEUWSEN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1218 W KILBOURN AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-1325
Mailing Address - Country:US
Mailing Address - Phone:414-276-6000
Mailing Address - Fax:
Practice Address - Street 1:1218 W KILBOURN AVE STE 301
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-1325
Practice Address - Country:US
Practice Address - Phone:414-276-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant