Individual
LUCAS ANDERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 260-2900
(608) 260-2956
Mailing address
1786 W GREENLAWN LN, APPLETON, WI 54914-6961
(920) 410-1550
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8463-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447134770
—
WI
Enumeration date
07/31/2025
Last updated
10/09/2025
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