Provider Demographics
NPI:1003884974
Name:STAATS, PATRICIA V (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:V
Last Name:STAATS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1217 GILBERT RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-3505
Mailing Address - Country:US
Mailing Address - Phone:608-274-3636
Mailing Address - Fax:
Practice Address - Street 1:1217 GILBERT RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-3505
Practice Address - Country:US
Practice Address - Phone:608-274-3636
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2020-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21883208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics