Dr Jack Hudson Deckard, MD is a
Neurological Surgery physician based in Glendale, Wisconsin. Dr Jack Hudson Deckard is licensed to practice in Wisconsin (license number 24495) and his current practice location is 5150 N Port Washington Rd, Ste 220, Glendale, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(414) 961-0089.
NPI number for Dr Jack Hudson Deckard is 1689618571 and his current mailing address is 5150 N Port Washington Rd, Ste 220, Glendale, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1689618571.
Physician's Profile
| Full Name | Dr Jack Hudson Deckard |
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| Gender | Male |
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| Speciality | Neurological Surgery |
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| Location | 5150 N Port Washington Rd, Glendale, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1689618571
- Provider Enumeration Date: 06/15/2006
- Last Update Date: 08/31/2010
Medical Identifiers
Medical identifiers for Dr Jack Hudson Deckard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1689618571 | NPI | - | NPPES |
| 30464900 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207T00000X | Neurological Surgery | 24495 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Hudson Deckard is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jack Hudson Deckard, MD
5150 N Port Washington Rd, Ste 220,
Glendale, WI 53217-5474
Ph: (414) 961-0089 | Dr Jack Hudson Deckard, MD
5150 N Port Washington Rd, Ste 220,
Glendale, WI 53217-5474
Ph: (414) 961-0089 |
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