Individual
LARRY E LACROSSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10625 W NORTH AVE, 102, MILWAUKEE, WI 53226-2315
(414) 877-5350
(414) 877-5360
Mailing address
10625 W NORTH AVE, 102, MILWAUKEE, WI 53226-2315
(414) 877-5350
(414) 877-5360
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
10435
HI
207P00000X
Emergency Medicine Physician
Primary
30441
WI
207P00000X
Emergency Medicine Physician
ME76912
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31664300
—
WI
Enumeration date
09/20/2006
Last updated
04/07/2017
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