Individual
JEANNE M LYKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
835 PARKSIDE ST, RIPON, WI 54971-8505
(920) 745-3560
(920) 926-8370
Mailing address
420 E DIVISION ST, FOND DU LAC, WI 54935-4560
(920) 926-8332
(920) 926-8370
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
34644
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31943400
—
WI
Enumeration date
09/07/2005
Last updated
10/26/2020
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