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General NPI Number Information
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NPI Number | 1982880837
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Entity Type | Organization
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Legal Business Name | STEWART F TAYLOR JR MD
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Dates
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Enumeration Date | 01/10/2008
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Last Update Date | 01/10/2008
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Provider Practice Location Address
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Address Line | 2817 NEW PINERY RD STE 202
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City | PORTAGE
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State | WI
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Zip | 53901-9257
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Country | US
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Telephone | 608-742-4242
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Fax |
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Provider Business Mailing Address
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Address Line | 2817 NEW PINERY RD STE 202
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City | PORTAGE
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State | WI
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Zip | 53901-9257
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Country | US
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Telephone | 608-742-4242
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | JACQUELINE WALTERS
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Credential |
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Telephone | 608-742-4242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 23326
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License Number State | WI
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