Provider Demographics
NPI:1811947476
Name:NEYENS, STEVEN PATRIC (OD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:PATRIC
Last Name:NEYENS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:963 W CLAIREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6103
Mailing Address - Country:US
Mailing Address - Phone:715-832-7723
Mailing Address - Fax:
Practice Address - Street 1:963 W CLAIREMONT AVE
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6103
Practice Address - Country:US
Practice Address - Phone:715-832-7723
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2604152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38592600Medicaid
WI38592600Medicaid
WIU52731Medicare UPIN