Picone, Samuel B

Picone, Samuel B is an individual health care provider with primary practice located at N9781 W Duck Lake Rd # Ktc130 , Summit Lake WI 54485-9629. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Picone, Samuel B can be contacted via phone (715) 443-4329.

Contact Information

Primary practice address
N9781 W Duck Lake Rd # Ktc130 Summit Lake WI 54485-9629
Phone: (715) 443-4329
Fax: (815) 366-3349
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 33904 Wisconsin
Allopathic & Osteopathic Physicians / Surgery 208600000X G037968 California
Allopathic & Osteopathic Physicians / Surgery 208600000X MD072888L Pennsylvania

Profile Details

NPI number 1942233630
LBN Legal business name Picone, Samuel B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2006
Last updated Jan 6th, 2014 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942233630 NPPES
Wisconsin MEDICAID 31885600

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