Organization
THAYER SURGICAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB THAYER MD (PRESIDENT)
(920) 627-2735
Entity
Organization
Contact information
Practice address
W307N1497 GOLF RD STE 200, DELAFIELD, WI 53018-2112
(920) 627-2735
Mailing address
1119 E GOODRICH LN, FOX POINT, WI 53217-2944
(920) 627-2735
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
05/04/2023
Last updated
05/04/2023
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