MEDICARE: JEFFREY J STEPHANY M.D.

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	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	38539	WI
2	207X00000X	Orthopaedic Surgery Physician	38539-020	WI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200045640	OTHER		RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1962406983
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY J STEPHANY M.D.

Provider Business Mailing Address
First Line	:	575 W RIVER WOODS PKWY
Second Line	:	STE 100
City	:	GLENDALE
State	:	WI
Zip	:	53212-1058
Country	:	US
Telephone Number	:	414-332-6262
Fax Number	:	414-332-0422

Provider Business Practice Location Address
First Line	:	525 W RIVER WOODS PARKWAY
Second Line	:	STE 130
City	:	GLENDALE
State	:	WI
Zip	:	53212
Country	:	US
Telephone Number	:	414-961-0304
Fax Number	:	414-961-2061

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

Provider Enumeration Date	:	06/08/2005
Last Update Date	:	10/24/2019

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Directions to “ JEFFREY J STEPHANY M.D.” Practice Location

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