Individual
JARED WYNN SQUIRES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-8296
(414) 805-6851
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-8296
(414) 805-6851
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
81953
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1417535790
—
WI
Enumeration date
03/30/2021
Last updated
07/11/2025
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