Healthcare Provider Details

I. General information

NPI: 1639255391
Provider Name (Legal Business Name): FAMILY HEALTH OF LAFAYETTE COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 11/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 CLAY ST
DARLINGTON WI
53530-1225
US

IV. Provider business mailing address

731 CLAY ST
DARLINGTON WI
53530-1225
US

V. Phone/Fax

Practice location:
  • Phone: 608-776-4497
  • Fax: 608-776-2317
Mailing address:
  • Phone: 608-776-4497
  • Fax: 608-776-2317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. LORI L NEUMANN
Title or Position: PARTNER
Credential: MD
Phone: 608-776-4497