Macias Tejada, Jonny Alexander
Macias Tejada, Jonny Alexander is an individual health care provider with primary practice located at 1020 N 12Th St Ste 301 , Milwaukee WI 53233-1308. He recently has only one registered license in Allopathic & Osteopathic Physicians / Geriatric Medicine, which is considered as his primary health care specialty. Macias Tejada, Jonny Alexander can be contacted via phone (414) 219-7300.Contact Information
Primary practice address
1020 N 12Th St Ste 301
Milwaukee WI 53233-1308
Phone: (414) 219-7300
Fax: (414) 219-7632
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207QG0300X | 52098-020 | Wisconsin |
| Allopathic & Osteopathic Physicians / Geriatric Medicine | 207RG0300X | 52098-020 | Wisconsin |
Profile Details
| NPI number | 1508075409 |
|---|---|
| LBN Legal business name | Macias Tejada, Jonny Alexander |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 21st, 2007 |
| Last updated | Nov 24th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508075409 | NPPES |
| Wisconsin | MEDICAID | 100005725 |
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