Organization
NEUROLOGICAL SURGERY CONSULTANTS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK HUDSON DECKARD M.D. (PRESIDENT)
(414) 961-0089
Entity
Organization
Contact information
Practice address
5150 N PORT WASHINGTON RD, SUITE 220, GLENDALE, WI 53217-5474
(414) 961-0089
(414) 691-1043
Mailing address
5150 N PORT WASHINGTON RD, SUITE 220, GLENDALE, WI 53217-5474
(414) 961-0089
(414) 691-1043
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
24495
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30464900
—
WI
Enumeration date
10/18/2006
Last updated
08/19/2010
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