Individual
MICHAEL JAMES LACAZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1050 GAIL GARDNER WAY STE 300, PRESCOTT, AZ 86305-1640
(928) 717-5232
(928) 717-5238
Mailing address
PO BOX 10880, PRESCOTT, AZ 86304-0880
(602) 406-4786
(916) 636-4358
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
006806
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006806
AZ LICENSE
AZ
05
—
1003161035
—
MI
05
—
Z192483
—
AZ
Enumeration date
07/16/2012
Last updated
02/17/2025
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