Individual
DR. ROBERT JOHN LACIAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
990 NW CIRCLE BLVD, SUITE 102, CORVALLIS, OR 97330-1967
(541) 768-5486
Mailing address
PO BOX 1189, CORVALLIS, OR 97339-1189
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
6851346-1205
UT
208800000X
Urology Physician
Primary
MD152679
OR
Other
Enumeration date
02/25/2008
Last updated
11/05/2020
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