Manley, Jack C

Manley, Jack C is an individual health care provider with primary practice located at 201 N Mayfair Rd , Wauwatosa WI 53226-4216. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Manley, Jack C can be contacted via phone (414) 259-7505.

Contact Information

Primary practice address
201 N Mayfair Rd Wauwatosa WI 53226-4216
Phone: (414) 259-7505
Fax: (414) 259-7583
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 13968 Wisconsin
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 13968 Wisconsin

Profile Details

NPI number 1851351274
LBN Legal business name Manley, Jack C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Mar 9th, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851351274 NPPES
Wisconsin MEDICAID 30897900

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