Provider Demographics
NPI:1952366023
Name:BUDLESKI, LUKE J (DO)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:J
Last Name:BUDLESKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3200 WESTHILL DR
Mailing Address - Street 2:STE 102
Mailing Address - City:WAUSAU
Mailing Address - State:WI
Mailing Address - Zip Code:54401-4705
Mailing Address - Country:US
Mailing Address - Phone:715-847-2019
Mailing Address - Fax:715-847-2668
Practice Address - Street 1:3200 WESTHILL DR
Practice Address - Street 2:STE 102
Practice Address - City:WAUSAU
Practice Address - State:WI
Practice Address - Zip Code:54401-4705
Practice Address - Country:US
Practice Address - Phone:715-847-2019
Practice Address - Fax:715-847-2668
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-20
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI48382208100000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program