Provider Demographics
NPI:1720410962
Name:STOOP, TYLER P (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:P
Last Name:STOOP
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 W WINNEBAGO ST
Mailing Address - Street 2:APT. 134
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53205-2561
Mailing Address - Country:US
Mailing Address - Phone:920-850-2047
Mailing Address - Fax:
Practice Address - Street 1:901 W WINNEBAGO ST
Practice Address - Street 2:APT. 134
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53205-2561
Practice Address - Country:US
Practice Address - Phone:920-850-2047
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI17163-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist