# SUBBANNA JAYAPRAKASH, M.D., S.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Rehabilitation Physicians of Racine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477527380
- **Authorized official:** SUBBANNA JAYAPRAKASH M.D. (OWNER)
- **Authorized official phone:** (262) 598-1001

## Contact information

- **Practice address:** 6015 DURAND AVE, 500, RACINE, WI 53406-5089
- **Practice address phone:** (262) 598-1001
- **Mailing address:** 6015 DURAND AVE, 500, RACINE, WI 53406-5089
- **Mailing address phone:** (262) 598-1001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | 27676 | WI | Yes |

## Other

- **Enumeration date:** 02/15/2006
- **Last updated:** 08/22/2020