Jimenez, Miguel A

Jimenez, Miguel A is an individual health care provider with primary practice located at 1969 W Hart Rd , Beloit WI 53511. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Jimenez, Miguel A can be contacted via phone (608) 364-5269.

Contact Information

Primary practice address
1969 W Hart Rd Beloit WI 53511
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 26724020 Wisconsin

Profile Details

NPI number 1063430767
LBN Legal business name Jimenez, Miguel A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 18th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063430767 NPPES
Wisconsin MEDICAID 30636900
Wisconsin Other 0360495311

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