Individual
JEFFREY WACKSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5434 GRAND LEGACY DR, MAINEVILLE, OH 45039-7787
(513) 494-0083
Mailing address
5434 GRAND LEGACY DR, MAINEVILLE, OH 45039-7787
(239) 949-0743
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
032688
OH
Other
Enumeration date
04/17/2013
Last updated
10/07/2014
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