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Individual
JOHN P LACEY JR.
Active
Individual
JOHN P LACEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
31345
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578645305
—
WI
01
—
7708
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/20/2006
Last updated
09/05/2013
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