Individual
DR. LUCY R CANADAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
107 E HIGHLAND DR, OCONTO FALLS, WI 54154-1002
(920) 846-3092
(920) 846-8313
Mailing address
PO BOX 22487, GREEN BAY, WI 54305-2487
(920) 445-7226
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47569-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1811958028
—
WI
01
—
9932148
BCBS
IL
Enumeration date
03/29/2006
Last updated
09/12/2019
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