Individual
JOHN R STANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
835 PARKSIDE ST, RIPON, WI 54971-8505
(920) 745-3520
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8340
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
208
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42904600
—
WI
Enumeration date
09/22/2005
Last updated
03/01/2016
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