Individual
STEPHEN R RUDISILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1650 LEE LANE, OCCUPATION HEALTH SPORTS & FAMILY MEDICINE CENTER, BELOIT, WI 53511-3935
(608) 362-0211
(608) 364-4670
Mailing address
1905 E. HUEBBE PARKWAY, BELOIT HEALTH SYSTEM INC, BELOIT, WI 53511-1842
(608) 364-2200
(608) 363-7395
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29225020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013925775
—
WI
Enumeration date
08/04/2006
Last updated
10/20/2011
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