Provider Demographics
NPI:1831278621
Name:MEIER, BRADLEY G (OD)
Entity type:Individual
Prefix:
First Name:BRADLEY
Middle Name:G
Last Name:MEIER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 5TH ST NE
Mailing Address - Street 2:P. O. BOX 1540
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-3711
Mailing Address - Country:US
Mailing Address - Phone:605-882-2220
Mailing Address - Fax:605-882-5675
Practice Address - Street 1:26 5TH ST NE
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:SD
Practice Address - Zip Code:57201-3711
Practice Address - Country:US
Practice Address - Phone:605-882-2220
Practice Address - Fax:605-882-5675
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD139152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist