Individual
BRUCE LUCCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3805B SPRING ST, SUITE 130, RACINE, WI 53405-1641
(262) 631-8750
(262) 631-8754
Mailing address
3805B SPRING ST, SUITE 130, RACINE, WI 53405-1641
(262) 631-8750
(262) 631-8754
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29473
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31555600
—
WI
Enumeration date
06/06/2006
Last updated
04/19/2011
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