Individual
JORGE TADEO PUCHOL CASTILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
85377-875
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1881587137
—
WI
Enumeration date
06/03/2025
Last updated
06/23/2025
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