Rudisill, Stephen R

Rudisill, Stephen R is an individual health care provider with primary practice located at 1650 Lee Lane Occupation Health Sports & Family Medicine Center, Beloit WI 53511-3935. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Rudisill, Stephen R can be contacted via phone (608) 362-0211.

Contact Information

Primary practice address
1650 Lee Lane Occupation Health Sports & Family Medicine Center Beloit WI 53511-3935
Phone: (608) 362-0211
Fax: (608) 364-4670
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29225020 Wisconsin

Profile Details

NPI number 1013925775
LBN Legal business name Rudisill, Stephen R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 4th, 2006
Last updated Oct 20th, 2011 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013925775 NPPES
Wisconsin MEDICAID 1013925775

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