| Lakeside Neurocare Limited | |
|
620 W Brown St Waupun WI 53963-1702 | |
| (920) 223-5580 | |
| (920) 223-3580 |
| Full Name | Lakeside Neurocare Limited |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 620 W Brown St, Waupun, Wisconsin |
| Authorized Official Name and Position | Susan M Golden (BUSINESS MANAGER) |
| Authorized Official Contact | 9202235582 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Neurocare Limited 2700 W 9th Ave Ste 225 Oshkosh WI 54904-7865 Ph: (920) 223-5582 | Lakeside Neurocare Limited 620 W Brown St Waupun WI 53963-1702 Ph: (920) 223-5580 |
| NPI Number | 1497234686 |
|---|---|
| Provider Enumeration Date | 08/09/2018 |
| Last Update Date | 08/09/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497234686 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 36421 (Wisconsin) | Primary |
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