| Purath Headache & Neurology, S.c. | |
|
565 Milwaukee Ave Burlington WI 53105-1254 | |
| (262) 694-5000 | |
| Not Available |
| Full Name | Purath Headache & Neurology, S.c. |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 565 Milwaukee Ave, Burlington, Wisconsin |
| Authorized Official Name and Position | Mark Richard Purath (ADMINISTRATOR) |
| Authorized Official Contact | 2626945000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Purath Headache & Neurology, S.c. 5244 Zachary Dr Mount Pleasant WI 53403-9795 Ph: (262) 694-5000 | Purath Headache & Neurology, S.c. 565 Milwaukee Ave Burlington WI 53105-1254 Ph: (262) 694-5000 |
| NPI Number | 1538507603 |
|---|---|
| Provider Enumeration Date | 06/11/2013 |
| Last Update Date | 06/11/2013 |
| Medicare PECOS PAC ID | 8820230576 |
|---|---|
| Medicare Enrollment ID | O20130809000338 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538507603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | 40525-20 (Wisconsin) | Primary |
| Provider Name | Traci A Purath |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891716700 PECOS PAC ID: 4385661396 Enrollment ID: I20051028000774 |
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