Dr. Jay L Mackman
Oral and Maxillofacial Pathology
2626 N 76th St
Wauwatosa
, Wisconsin 53213
Dr. Jay L Mackman
Oral and Maxillofacial Pathology
2626 N 76th St
Wauwatosa
, Wisconsin 53213
(414) 476-9400
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About
Features
Specialties
- Oral and Maxillofacial Pathology
Languages spoken
- English
Location
First Address
- Dr. Jay L Mackman
- 2626 N 76th St
- Wauwatosa, WI
- Zip : 53213
- Phone : (414) 476-9400
Second Address
- Dr. Jay L Mackman
- 2626 N 76th St
- Wauwatosa, WI
- Zip : 53213
- Phone : (414) 476-9400
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223P0106X | Oral and Maxillofacial Pathology | 2793-015 | WI |
National Provider Identifier
| NPI | 1821194184 |
|---|---|
| Provider Name | Dr. Jay L Mackman |
| First Address | Wauwatosa, WI 53213 |
| Second Address | Wauwatosa, WI 53213 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/09/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T62660 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.