Luccas, Bruce
Luccas, Bruce is an individual health care provider with primary practice located at 3805B Spring St Suite 130, Racine WI 53405-1641. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Luccas, Bruce can be contacted via phone (262) 631-8750.Contact Information
Primary practice address
3805B Spring St Suite 130
Racine WI 53405-1641
Phone: (262) 631-8750
Fax: (262) 631-8754
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 29473 | Wisconsin |
Profile Details
| NPI number | 1972543452 |
|---|---|
| LBN Legal business name | Luccas, Bruce |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 6th, 2006 |
| Last updated | Apr 19th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972543452 | NPPES |
| Wisconsin | MEDICAID | 31555600 |
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