NPI 1003829649

Mark D. Jakubek

Practitioner Specialist La Crosse, WI

Practice location

Address: 1725 State St, La Crosse, WI 54601-3742
Phone: (920) 642-0201
Mailing address: 1013 State St APT 8, La Crosse, WI 54601-3495

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 761-039 (WI)

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Registry record

NPI: 1003829649
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Aug 2006
Record last updated: 8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.