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Individual

DR. RICHARD WILLIAM LUCIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2055 15TH ST N, SAINT CLOUD, MN 56303-1747
(320) 251-1432
(320) 251-7122
Mailing address
2055 15TH ST N, SAINT CLOUD, MN 56303-1747
(320) 251-1432
(320) 251-7122

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
40570
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0807403
MEDICA
MN
05
126327700
MN
01
180033446
RAILROAD MEDICARE
01
46Q20LU
BLUE CROSS
MN
Enumeration date
10/07/2005
Last updated
02/20/2012
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