| Doctor Name: | PATRICK J PUCELIK |
| NPI Number: | 1649247362 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | A-106028 |
| Business Practice Address: | 153 Blair St Whiting, IA - 510631007 |
| Business Phone Number: | 7124552431 |
| Business Fax Number: | 7124552698 |
| Mailing Address: | 153 Blair St, WHITING |
| State: | IA |
| Postal Code: | 510631007 |
| Phone Number: | 7124552431 |
| Fax Number: | 7124552698 |
| NPI Enumeration Date: | 03/01/2006 |
| NPI Last Update Date: | 05/21/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | A-106028 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |