Quezada, Jaime
Quezada, Jaime is an individual health care provider with primary practice located at 350 Peller Rd , Lake Geneva WI 53147-4543. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Quezada, Jaime can be contacted via phone (262) 249-0221.Contact Information
Primary practice address
350 Peller Rd
Lake Geneva WI 53147-4543
Phone: (262) 249-0221
Fax: (262) 249-0633
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 36520 | Wisconsin |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 47086-20 | Wisconsin |
Profile Details
| NPI number | 1356432660 |
|---|---|
| LBN Legal business name | Quezada, Jaime |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 28th, 2006 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1356432660 | NPPES |
| Wisconsin | MEDICAID | 34581200 |
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