Individual
LUCAS FASS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 HIGHLAND AVE, MADISON, WI 53792-1465
(608) 628-3664
Mailing address
600 HIGHLAND AVE, MADISON, WI 53792-0001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
81575-20
WI
207RG0100X
Gastroenterology Physician
Primary
81575-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/02/2019
Last updated
06/09/2025
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