Provider Demographics
NPI:1538276498
Name:WOZNICKI, PATRICIA M (OD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:M
Last Name:WOZNICKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:830 W MICHIGAN AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1446
Mailing Address - Country:US
Mailing Address - Phone:269-781-9822
Mailing Address - Fax:269-781-9839
Practice Address - Street 1:830 W MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1446
Practice Address - Country:US
Practice Address - Phone:269-781-9822
Practice Address - Fax:269-781-9839
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901003201152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2220022OtherPHP
MI30416OtherHEALTH PLAN OF MI
MI944630181Medicaid
MIMI3201OtherEYEMED
MISC1628189OtherCLARITY VISION
MI230886OtherNVA
MI900A311030OtherBCBSM
MI24032OtherSPECTERA
MIP00232105OtherRAILROAD MEDICARE
MI5348270002OtherADMINISTAR FEDERAL
MIVC380005OtherMCARE
MI5176293981OtherVSP
MI5176293981OtherVSP
MIU32630Medicare UPIN