Individual
JONATHAN GULLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, PALLIATIVE CARE-CANCER CENTER BUILDING, MILWAUKEE, WI 53226-3522
(414) 805-4607
(414) 805-4608
Mailing address
9200 W WISCONSIN AVE, PALLIATIVE CARE-CANCER CENTER BUILDING, MILWAUKEE, WI 53226-3522
(414) 805-4607
(414) 805-4608
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
235276
MA
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
53292
WI
207RH0003X
Hematology & Oncology Physician
53292
WI
208000000X
Pediatrics Physician
53292-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568650158
—
WI
Enumeration date
10/09/2007
Last updated
11/22/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us