Individual
PHILLIP L. STALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3793
Mailing address
10 TOWER DR, SUN PRAIRIE, WI 53590-1239
(608) 825-3500
(608) 825-3793
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
73247-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336529932
—
WI
Enumeration date
06/09/2015
Last updated
01/07/2022
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