Jay M Miesfeld, MD | |
109 Warren St Ste 4, Beaver Dam, WI 53916-3082 | |
(920) 885-3305 | |
(920) 885-5506 |
Full Name | Jay M Miesfeld |
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Gender | Male |
Speciality | Pediatrics |
Location | 109 Warren St Ste 4, Beaver Dam, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1437354602 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | R-8095 (Iowa) | Secondary |
208000000X | Pediatrics | 54813-20 (Wisconsin) | Primary |
Entity Name | University Of Wisconsin Medical Foundation Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1598784555 PECOS PAC ID: 6608785464 Enrollment ID: O20031111000435 |
Entity Name | Community Pediatrics Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1275749566 PECOS PAC ID: 8729015409 Enrollment ID: O20050725000693 |
Mailing Address | Practice Location Address |
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Jay M Miesfeld, MD 7974 Uw Health Ct, Middleton, WI 53562-5531 Ph: () - | Jay M Miesfeld, MD 109 Warren St Ste 4, Beaver Dam, WI 53916-3082 Ph: (920) 885-3305 |
Dr. Jessica L Miesfeld, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 109 Warren St, Ste 4, Beaver Dam, WI 53916 Phone: 920-885-3305 Fax: 920-885-5506 | |
Dr. Elizabeth Michael Peterson, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 109 Warren St, Suite 4, Beaver Dam, WI 53916 Phone: 920-885-3305 |