| Doctor Name: | DR. JASON ERIC STASZKO |
| NPI Number: | 1770630253 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 2005-01282 |
| Business Practice Address: | 2323 N Lake Dr Milwaukee, WI - 532114508 |
| Business Phone Number: | 4142906720 |
| Business Fax Number: | 4142906755 |
| Mailing Address: | 111 E Wisconsin Ave, Suite 2000 MILWAUKEE |
| State: | WI |
| Postal Code: | 532024815 |
| Phone Number: | 4142906720 |
| Fax Number: | 4142906755 |
| NPI Enumeration Date: | 01/05/2007 |
| NPI Last Update Date: | 07/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 2005-01282 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |