Individual
JACOB LAINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2801 W KINNICKINNIC RIVER PKWY STE 1080, MILWAUKEE, WI 53215-3689
(414) 908-6506
(414) 908-6510
Mailing address
2801 W KINNICKINNIC RIVER PKWY STE 1080, MILWAUKEE, WI 53215-3689
(414) 908-6506
(414) 908-6510
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
66853-20
WI
207RG0100X
Gastroenterology Physician
Primary
66853-20
WI
Other
Enumeration date
04/09/2015
Last updated
01/26/2026
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