NPI 1194210492

Jacob Tyler McCallum, DO

Practitioner Diagnostic Radiology Physician Middleton, WI

Practice location

Address: 8430 Market St APT 118, Middleton, WI 53562-4782
Phone: (612) 328-1583

Registered specialties (2)

Diagnostic Radiology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 81114 (WI)

Other Radiology providers in Wisconsin →

Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X Licence 5101024188 (MI)

Registry record

NPI: 1194210492
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jun 2018
Record last updated: 23 Jul 2024

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.