| Lakeside Neurocare | |
|
855 N Westhaven Dr Oshkosh WI 54904-7668 | |
| (920) 223-5580 | |
| (920) 223-3580 |
| Full Name | Lakeside Neurocare |
|---|---|
| Speciality | Psychiatry & Neurology - Neurology |
| Location | 855 N Westhaven Dr, Oshkosh, 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 2700 W 9th Ave Ste 225 Oshkosh WI 54904-7865 Ph: (920) 223-5580 | Lakeside Neurocare 855 N Westhaven Dr Oshkosh WI 54904-7668 Ph: (920) 223-5580 |
| NPI Number | 1083048730 |
|---|---|
| Provider Enumeration Date | 08/29/2013 |
| Last Update Date | 08/29/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083048730 | NPI | - | NPPES |
| 32820600 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | (Wisconsin) | Primary |
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