Individual
DR. JACQUES C THAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1720 HARDING AVE STE 1, EAU CLAIRE, WI 54701-4861
(715) 832-2200
Mailing address
1720 HARDING AVE STE 1, EAU CLAIRE, WI 54701-4861
(715) 832-2200
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
100115
GA
2085R0204X
Vascular & Interventional Radiology Physician
51388020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002520205
MEDICARE PTAN
WI
05
—
35328400
—
WI
Enumeration date
06/17/2008
Last updated
05/23/2024
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