MEDICARE: DR. JOSEPH LAYDE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	23127	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265483770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH LAYDE MD

Provider Business Mailing Address
First Line	:	1155 N MAYFAIR RD
Second Line	:	BEHAVIORAL HEALTH CLINIC @ TOSA
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3421
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1155 N MAYFAIR RD
Second Line	:	BEHAVIORAL HEALTH CLINIC @ TOSA
City	:	MILWAUKEE
State	:	WI
Zip	:	53226-3421
Country	:	US
Telephone Number	:	414-805-3666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2006
Last Update Date	:	07/08/2007

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