Individual
DR. STACY D O'CONNOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Mailing address
9200 W WISCONSIN AVE, DEPT OF RADIOLOGY, MILWAUKEE, WI 53226-3522
(414) 805-3700
(414) 805-3777
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
247150
MA
2085R0202X
Diagnostic Radiology Physician
Primary
51608-020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588854616
—
WI
Enumeration date
07/25/2007
Last updated
08/11/2015
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