NPI 1457335523

Timothy S Staacke, MD

Practitioner Interventional Pain Medicine Physician Kenosha, WI

Practice location

Address: 10400 75th St, Kenosha, WI 53142-7884
Phone: (262) 697-7000
Mailing address: 225 S Executive Dr, Brookfield, WI 53005-4266

Registered specialties (3)

Interventional Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0014X Licence 39495 (WI)

Other Pain Medicine providers in Wisconsin →

Anesthesiology Physician

Allopathic & Osteopathic Physicians Taxonomy 207L00000X Licence 39495-020 (WI)

Other Anesthesiology providers in Wisconsin →

Pain Medicine (Anesthesiology) Physician

Allopathic & Osteopathic Physicians Taxonomy 207LP2900X Licence 39495 (WI)

Registry record

NPI: 1457335523
Entity type: Individual
Sex (as registered): Male
NPI issued: 2 Dec 2005
Record last updated: 29 Jun 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.