Individual
DR. JACK R TENGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11020 W PLANK CT, SUITE 100, WAUWATOSA, WI 53226-3279
(414) 256-5587
(414) 476-2976
Mailing address
14275 MIDWAY RD, SUITE 400, ADDISON, TX 75001-3614
(610) 271-4245
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
19340
WI
Other
Enumeration date
01/09/2006
Last updated
05/01/2015
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