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Individual

VICTORIJA D LAUCIUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2550 ADDISON AVE E, SUITE E, TWIN FALLS, ID 83301-6749
(208) 814-7780
(208) 814-7746
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
O164
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003794600
ID
01
P00306801
RR MEDICARE
ID
Enumeration date
06/07/2006
Last updated
12/29/2014
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