Provider Demographics
NPI:1730359928
Name:MESMER, JEFF (HIS)
Entity type:Individual
Prefix:
First Name:JEFF
Middle Name:
Last Name:MESMER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 WALNUT ST
Mailing Address - Street 2:A
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-1859
Mailing Address - Country:US
Mailing Address - Phone:812-926-4567
Mailing Address - Fax:812-926-2342
Practice Address - Street 1:432 WALNUT ST
Practice Address - Street 2:A
Practice Address - City:LAWRENCEBURG
Practice Address - State:IN
Practice Address - Zip Code:47025-1859
Practice Address - Country:US
Practice Address - Phone:812-926-4567
Practice Address - Fax:812-926-2342
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001272A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist