Individual
STEPHEN J BRUBAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20594
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31104300
—
WI
Enumeration date
06/10/2005
Last updated
07/13/2010
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