Individual
JARED L STAHLECKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
849 KELLOGG AVE, JANESVILLE, WI 53546-2808
(608) 755-7960
(608) 755-7873
Mailing address
849 KELLOGG AVE, JANESVILLE, WI 53546-2808
(608) 755-7960
(608) 755-7873
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
64449-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
64449-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000054176-K400239660
WI MEDICARE
WI
01
—
1255708129
BCBSWI
WI
05
—
1255708129
—
WI
01
—
STAHLJAR
MERCYCARE INSURANCE
WI
Enumeration date
08/27/2015
Last updated
07/21/2022
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