Individual
TIMOTHY LAZICKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5222
Mailing address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5222
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
66782
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1538554910
—
WI
Enumeration date
04/01/2015
Last updated
11/11/2021
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