Provider Demographics
NPI:1942342704
Name:ALBA, JOSE J (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:J
Last Name:ALBA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:206 COURT ST
Mailing Address - Street 2:
Mailing Address - City:CHILTON
Mailing Address - State:WI
Mailing Address - Zip Code:53014-1127
Mailing Address - Country:US
Mailing Address - Phone:920-849-1400
Mailing Address - Fax:920-849-1468
Practice Address - Street 1:206 COURT ST
Practice Address - Street 2:
Practice Address - City:CHILTON
Practice Address - State:WI
Practice Address - Zip Code:53014-1127
Practice Address - Country:US
Practice Address - Phone:920-849-1400
Practice Address - Fax:920-849-1468
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI27526-202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI31383100Medicaid
WI31383100Medicaid
WI31383100Medicaid