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Contact Information

JEFFREY K CHISM, DPM
410 E 2ND ST
MERRILL, WI54452-2319
 Phone: 715-536-7444
 Fax: 715-536-1547
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JEFFREY K CHISM · (Male)

NPI # 1285621730
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 09/30/2005
Last updated 05/01/2009 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • WI License # 748-025
  • WI Medicaid 43223800
  • WI Other 1285621730 BLUE CROSS FEDERAL EMPLOYEE PROGRAM
  • WI Other 000000485016 WI BLUE SHIELD
Hospital affiliation(s) Not Available
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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