Individual
JOHN JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1517 RUE REYNARD ST, MENASHA, WI 54952-2946
(920) 725-5718
Mailing address
1517 RUE REYNARD ST, MENASHA, WI 54952-2946
(920) 725-5718
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
39628020
WI
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
39628-020
WI
Other
Enumeration date
07/07/2006
Last updated
09/30/2011
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