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General NPI Number Information
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NPI Number | 1750504346
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Entity Type | Organization
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Legal Business Name | V. STEPHEN SLANA, M.D., S.C.
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 06/24/2008
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Provider Practice Location Address
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Address Line | 6125 GREEN BAY RD STE 800
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City | KENOSHA
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State | WI
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Zip | 53142-2982
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Country | US
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Telephone | 262-654-0726
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Fax | 262-654-4365
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Provider Business Mailing Address
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Address Line | 6125 GREEN BAY RD STE 800
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City | KENOSHA
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State | WI
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Zip | 53142-2982
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Country | US
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Telephone | 262-654-0726
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Fax | 262-654-4365
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Authorized Official
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Title or Position | PHYSICIAN
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Name | VICTOR STEPHEN SLANA
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Credential |
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Telephone | 262-654-0726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 32916
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License Number State | WI
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