Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | AZ 1668 | AZ |
NPI | 1073733481 |
---|---|
Provider Name | Dr. John James Stropko |
First Address | Prescott, AZ 86305-5615 |
Second Address | Prescott, AZ 86305-5615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2007 |
Last Update Date | 22/02/2012 |