Individual
GUY R LORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1035 W GLEN OAKS LN, SUITE 204, MEQUON, WI 53092-3392
(262) 512-9400
Mailing address
PO BOX 639, CEDARBURG, WI 53012-0639
(262) 512-9400
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
21036020
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30496000
—
WI
Enumeration date
05/02/2006
Last updated
10/23/2013
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