Provider Demographics
NPI:1225016942
Name:NEUMAN, PATRICIA LYNN (DO)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:LYNN
Other - Last Name:MOTYCKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:2366 OAK RIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:DE PERE
Mailing Address - State:WI
Mailing Address - Zip Code:54115-9207
Mailing Address - Country:US
Mailing Address - Phone:920-338-1111
Mailing Address - Fax:920-339-6795
Practice Address - Street 1:2366 OAK RIDGE CIR
Practice Address - Street 2:
Practice Address - City:DE PERE
Practice Address - State:WI
Practice Address - Zip Code:54115-9207
Practice Address - Country:US
Practice Address - Phone:920-338-1111
Practice Address - Fax:920-339-6795
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2011-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI49153208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43529600Medicaid
MN211000800Medicaid
WI07125-0336Medicare PIN
H91418Medicare UPIN