Healthcare Provider Details

I. General information

NPI: 1750918868
Provider Name (Legal Business Name): JOSEPH AARON JEFFRIES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 01/22/2025
Certification Date: 01/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 W WATERTOWN PLANK RD FL 8
MILWAUKEE WI
53226-3548
US

IV. Provider business mailing address

8701 W WATERTOWN PLANK RD FL 8
MILWAUKEE WI
53226-3548
US

V. Phone/Fax

Practice location:
  • Phone: 414-955-4578
  • Fax:
Mailing address:
  • Phone: 414-955-4578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number77263-20
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number77263-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: