Provider Demographics
NPI:1447404553
Name:DRJ & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:DRJ & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:E
Authorized Official - Last Name:TAXMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:262-241-7778
Mailing Address - Street 1:11501 N PORT WASHINGTON RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MEQUON
Mailing Address - State:WI
Mailing Address - Zip Code:53092-3465
Mailing Address - Country:US
Mailing Address - Phone:262-241-7778
Mailing Address - Fax:
Practice Address - Street 1:11501 N PORT WASHINGTON RD
Practice Address - Street 2:SUITE 202
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-3465
Practice Address - Country:US
Practice Address - Phone:262-241-7778
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-17
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty