Individual
JOHN ELMER BUKOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2000 E LAYTON AVE STE 130, ST FRANCIS, WI 53235
(414) 747-8856
(262) 303-5006
Mailing address
2000 E LAYTON AVE STE 130, ST FRANCIS, WI 53235-6067
(414) 747-8856
(262) 303-5006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1861903130
—
WI
Enumeration date
10/13/2017
Last updated
11/29/2021
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