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Individual
JACKLYN MAYE ENGELBART
Active
Individual
JACKLYN MAYE ENGELBART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD-56877
IA
208600000X
Surgery Physician
R-11210
IA
2086S0102X
Surgical Critical Care Physician
MD-56877
IA
2086S0127X
Trauma Surgery Physician
MD-56877
IA
390200000X
Student in an Organized Health Care Education/Training Program
Primary
4301513544
MI
Other
Enumeration date
05/23/2018
Last updated
08/31/2026
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