DR. JACK HUDSON DECKARD (NPI# 1689618571) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1689618571 |
Entity Type | Individual |
Full Name | DR. JACK HUDSON DECKARD |
Credential | MD |
Practice Address |
5150 N Port Washington Rd Ste 220 Glendale WI 53217-5474 |
Practice Telephone | 4149610089 |
Practice Fax Number | 4149611043 |
Mailing Telephone | 4149610089 |
Mailing Fax Number | 4149611043 |
Enumeration Date | 2006-06-15 |
Last Update Date | 2010-08-31 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207T00000X | Neurological Surgery | 24495 | WI | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WI | 30464900 | 05 |
Street Address |
5150 N PORT WASHINGTON RD STE 220 |
City | GLENDALE |
State | WI |
Zip Code | 53217-5474 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1205433778 | Great Lakes Hospice LLC | Hospice Care, Community Based | 5150 N Port Washington Rd, Glendale, WI 53217-5474 | 2020-10-07 |
1528200599 | Heidi Elizabeth Bares Weidner | Physical Therapist | 5150 N Port Washington Rd, #130, Glendale, WI 53217-5474 | 2009-04-06 |
1235210907 | Neurological Surgery Consultants, Ltd | Specialist | 5150 N Port Washington Rd, Suite 220, Glendale, WI 53217-5474 | 2006-10-18 |
1366531865 | Paul D Mandel Md Sc | Ophthalmology | 5150 N Port Washington Rd, Suite 167, Glendale, WI 53217-5474 | 2006-10-12 |
1336237312 | Paul D Mandel | Ophthalmology | 5150 N Port Washington Rd, Suite 167, Glendale, WI 53217-5474 | 2006-10-11 |
1003918913 | Bruce E Holmstrom | Dentist | 5150 N Port Washington Rd, Suite 201, Glendale, WI 53217-5474 | 2006-09-01 |
1114029048 | Bruce Holmstrom D.d.s.,sc | Dentist | 5150 N Port Washington Rd, Suite 201, Glendale, WI 53217-5474 | 2006-09-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922632587 | Jasmine Dockery | Pharmacist | 5400 N Port Washington, Glendale, WI 53217 | 2020-02-23 |
1174017339 | North Lakes Nursing Home Health Care Agency LLC | Home Health | 225 E Fairmount Ave, Milwaukee, WI 53217 | 2018-06-20 |
1083140289 | Miriah Ann King, Ms, Lpc | Counselor | 7805 North Boyd Way, Fox Point, WI 53217 | 2017-05-08 |
1245783067 | Lakesha L Jones | Counselor | 5235 N Ironwood Rd, Glendale, WI 53217 | 2016-07-28 |
1750783312 | Ibrahim S Abouzeid | Specialist/Technologist, Other | 333 W Brown Deer Road, #240, Milwaukee, WI 53217 | 2014-09-25 |
1255733598 | Victoria Gorodetsky | Pharmacist | 229 W Indian Creek Ct, Milwaukee, WI 53217 | 2014-09-18 |
1174800049 | John Herman Esser | Internal Medicine | 1050 W Acacia Rd, Milwaukee, WI 53217 | 2011-11-07 |
1710298351 | Leann M Harman | Physical Therapist | 5333 N Port Washington Rd Ste B, Glendale, WI 53217 | 2010-06-29 |
1306012455 | Emily Marie Gallagher | Speech-Language Pathologist | 6700 N. Port Washington Road, Milwaukee, WI 53217 | 2008-05-07 |
1164625455 | Mary Catherine Enderlin | Psychologist | 6110 N Port Washington Road, The Cambridge Group, Glendale, WI 53217 | 2007-06-06 |
Find all providers in zip 53217 |
Taxonomy Code | 207T00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Neurological Surgery |
A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295254050 | Glendale Back and Pain Center | Neurological Surgery | 710 S. Central Ave, Suite 240, Glendale, CA 91204 | 2017-09-13 |
1457748055 | Patrick Wade | Neurological Surgery | 1016 E Broadway Ste 100, Glendale, CA 91205-4533 | 2015-04-21 |
1275724320 | Yaser Badr | Neurological Surgery | 1500 E Chevy Chase Dr Ste 204, Glendale, CA 91206-4152 | 2007-08-05 |
1801003686 | Mikayel Grigoryan | Neurological Surgery | 1500 E Chevy Chase Dr # 204, Glendale, CA 91206-4152 | 2007-05-17 |
1699828194 | Pacific Hills Neurosurgical Medical Group, Inc | Neurological Surgery | 1505 Wilson Ter, Suite 300, Glendale, CA 91206-4071 | 2007-01-19 |
1629128285 | Rajendra K. Tiwari, M.d., Professional Corporation | Neurological Surgery | 1500 S Central Ave, #314, Glendale, CA 91204-2573 | 2007-01-12 |
1386793198 | Rajendra K Tiwari | Neurological Surgery | 1500 S Central Ave, #314, Glendale, CA 91204-4800 | 2007-01-10 |
1083798607 | Kyoo S, Ro, M.d., Inc. | Neurological Surgery | 435 Arden Ave, #380, Glendale, CA 91203-1130 | 2006-10-24 |
1083613897 | Kyoo Sang Ro | Neurological Surgery | 435 Arden Ave, 380, Glendale, CA 91203-1130 | 2005-07-14 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1528350436 | Craig R Kelman | Neurological Surgery | 425 Pine Ridge Blvd Ste 300, Wausau, WI 54401 | 2011-05-11 |
1952545014 | Irene Kim | Neurological Surgery | 999 N 92nd St Ste 310, Milwaukee, WI 53226-4875 | 2009-04-20 |
1649419169 | Walter P Jacobsen | Neurological Surgery | 2801 W Kinnickinnic River Pkwy Ste 680, Milwaukee, WI 53215-3669 | 2009-02-05 |
1538324793 | Jose Luis Salazar | Neurological Surgery | 3220 N Shore Dr, Delavan, WI 53115-3800 | 2008-07-26 |
1205094711 | Bruce Clarke Bressler | Neurological Surgery | 3117 Bay View Dr, Green Bay, WI 54311-5909 | 2008-05-30 |
1154506921 | Werner E Langheim | Neurological Surgery | 4505 Fox Bluff Lane, Middleton, WI 53562-2327 | 2007-12-29 |
1427251339 | Pedro Daniel Suberviola | Neurological Surgery | 3255 Yale Ct, Brookfield, WI 53005-2772 | 2007-06-07 |
1831212778 | Allan Bertram Levin | Neurological Surgery | 4585 Fox Bluff Ln, Middleton, WI 53562-2327 | 2007-04-07 |
1013093178 | Cully R White | Neurological Surgery | 2901 W Kinnickinnic River Parkway, Suite 201, Milwaukee, WI 53215 | 2006-10-31 |
1538269402 | Christopher I. Mackay | Neurological Surgery | 2800 Westhill Dr., Suite 200, Wausau, WI 54407-3770 | 2006-09-22 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.