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General NPI Number Information
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NPI Number | 1831328707
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN JUDD IRWIN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/13/2009
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 1615 MAPLE LANE
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City | ASHLAND
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State | WI
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Zip | 54806
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Country | US
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Telephone | 715-685-6010
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Fax | 715-682-0738
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Provider Business Mailing Address
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Address Line | 1615 MAPLE LANE
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City | ASHLAND
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State | WI
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Zip | 54806
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Country | US
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Telephone | 715-685-6010
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Fax | 715-682-0738
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 4301094318
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License Number State | MI
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