Provider Demographics
NPI:1346240959
Name:FLANAGAN, W. PATRICK JR (MD)
Entity Type:Individual
Prefix:DR
First Name:W. PATRICK
Middle Name:
Last Name:FLANAGAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111 DELAFIELD ST
Mailing Address - Street 2:SUITE 12
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53188-3417
Mailing Address - Country:US
Mailing Address - Phone:262-542-9707
Mailing Address - Fax:262-542-9708
Practice Address - Street 1:1111 DELAFIELD ST
Practice Address - Street 2:SUITE 12
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53188-3417
Practice Address - Country:US
Practice Address - Phone:262-542-9707
Practice Address - Fax:262-542-9708
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI29199208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI0004094202OtherAETNA
WI180481OtherMULTIPLAN NETWORK
WI1309880001OtherDMERC/ADMINISTAR FEDERAL
WI1900025OtherUNITEDHEALTH CARE
WI31395600Medicaid
WI31395600Medicaid