Individual
DR. KYLE LENDON LACY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
211 S HENRY ST UNIT 403, MADISON, WI 53703-4793
(662) 418-4076
Mailing address
211 S HENRY ST UNIT 403, MADISON, WI 53703-4793
(662) 418-4076
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13894379-1205
UT
2085R0202X
Diagnostic Radiology Physician
73832-20
WI
Other
Enumeration date
04/03/2018
Last updated
07/01/2024
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