Individual
DR. MARCUS J NEITZKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3228 TURNBERRY OAK DR, SUITE 200, WAUKESHA, WI 53188-3969
(262) 542-7113
(262) 542-9439
Mailing address
3228 TURNBERRY OAK DR, SUITE 200, WAUKESHA, WI 53188-3969
(262) 542-7113
(262) 542-9439
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2760
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
38608500
—
WI
01
—
P00327818
PALMETTO GBA-RAILROAD MEDICARE
WI
Enumeration date
08/15/2005
Last updated
12/16/2008
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