Most Relevant Information
Provider Data
| NPI Number: | 1003435074 |
| Provider Name: | WILLIAM GRANT STOOKSBURY MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/10/2020 |
| Last Updated: | 04/10/2020 |
Provider Practice Location
8701 W WATERTOWN PLANK RD
MILWAUKEE
WI
532263548
Practice Location Phone/Fax
| Phone: | 4149558998 |
| Fax: |
Provider Mailing Location
8701 W WATERTOWN PLANK RD
MILWAUKEE
WI
532263548
Provider Mailing Phone/Fax
| Phone: | 4149558998 |
| Fax: |