Individual
DR. JACK-KY WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1905 E. HUEBBE PARKWAY, BELOIT HEALTH SYSTEM, INC, BELOIT, WI 53511-1842
(608) 364-2410
(608) 364-1287
Mailing address
1905 E. HUEBBE PARKWAY, BELOIT HEALTH SYSTEM, INC, BELOIT, WI 53511-1842
(608) 364-2410
(608) 364-1287
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-108395
IL
207Q00000X
Family Medicine Physician
Primary
50353-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093744617
—
WI
Enumeration date
07/03/2006
Last updated
10/20/2011
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