Provider Demographics
NPI:1295914299
Name:LIKNESS, LINCOLN PAUL (DO)
Entity type:Individual
Prefix:DR
First Name:LINCOLN
Middle Name:PAUL
Last Name:LIKNESS
Suffix:
Gender:M
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:2651 HILLCREST DRIVE
Mailing Address - Street 2:SUITE 303
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-4439
Mailing Address - Country:US
Mailing Address - Phone:715-531-6800
Mailing Address - Fax:715-531-6801
Practice Address - Street 1:2651 HILLCREST DRIVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-4439
Practice Address - Country:US
Practice Address - Phone:715-531-6800
Practice Address - Fax:715-531-6801
Is Sole Proprietor?:No
Enumeration Date:2007-10-26
Last Update Date:2023-06-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WI49791-021207QS0010X
WI49791207QS0010X, 204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine