Individual
JON L. PRYOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9200 W WISCONSIN AVE, DEPARTMENT OF UROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-0805
(414) 805-0771
Mailing address
9200 W WISCONSIN AVE, DEPARTMENT OF UROLOGY, MILWAUKEE, WI 53226-3522
(414) 805-0805
(414) 805-0771
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
34340
MN
208800000X
Urology Physician
Primary
54002
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0255504
PREFERRED ONE
MN
05
—
0988162
—
IA
01
—
101399
UCARE
MN
05
—
1124101886
—
WI
05
—
148007300
—
MN
01
—
19-00018
MEDICA PRIMARY
MN
01
—
19-00606
MEDICA CHOICE
MN
01
—
2T448PR
BLUE CROSS BLUE SHIELD
MN
01
—
603764
ARAZ
MN
01
—
HP14204
HEALTH PARTNERS
MN
Enumeration date
10/23/2006
Last updated
01/31/2013
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