Individual
DR. JON CHARLES STEPHENSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
109 N 28TH ST E, SUPERIOR, WI 54880-6548
(715) 395-3930
Mailing address
109 N 28TH ST E, SUPERIOR, WI 54880-6548
(715) 395-3930
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21317
WI
Other
Enumeration date
05/13/2006
Last updated
10/19/2007
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