MEDICARE: STEPHEN J HARROLD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	48122	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871575167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEPHEN J HARROLD MD

Provider Business Mailing Address
First Line	:	2651 HILLCREST DRIVE
Second Line	:	SUITE 303
City	:	HUDSON
State	:	WI
Zip	:	54016-4439
Country	:	US
Telephone Number	:	715-531-6800
Fax Number	:	715-531-6801

Provider Business Practice Location Address
First Line	:	525 N KNOWLES AVE
Second Line	:	SUITE 100
City	:	NEW RICHMOND
State	:	WI
Zip	:	54017-1218
Country	:	US
Telephone Number	:	715-531-6800
Fax Number	:	715-531-6801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2005
Last Update Date	:	05/31/2023

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