Provider Demographics
NPI:1336699099
Name:INTERGRATED TMS, LLC
Entity Type:Organization
Organization Name:INTERGRATED TMS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:TAXMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-241-8100
Mailing Address - Street 1:1045 W GLEN OAKS LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3467
Mailing Address - Country:US
Mailing Address - Phone:262-241-8100
Mailing Address - Fax:
Practice Address - Street 1:1045 W GLEN OAKS LN
Practice Address - Street 2:SUITE 1
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3467
Practice Address - Country:US
Practice Address - Phone:262-241-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI262272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty