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Contact Information

JONNY A MACIAS TEJADA, MD
2900 W OKLAHOMA AVE
MILWAUKEE, WI53215-4330
 Phone: 414-649-6000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207RG0300X 11 Physician/Internal Medicine
 

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JONNY A MACIAS TEJADA · (Male)

NPI Number 1508075409
Status Active
Credentials MD
Entity Individual
Enumeration date 05/21/2007
Last updated 09/24/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • WI License # 52098-020
  • WI Medicaid 100005725
Hospital affiliation(s)
  • AURORA ST LUKES MEDICAL CENTER - (Acute Care)
    2900 W OKLAHOMA AVE
    MILWAUKEE, WI 53215
  • AURORA WEST ALLIS MEDICAL CENTER - (Acute Care)
    8901 W LINCOLN AVE
    WEST ALLIS, WI 53227
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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