Doctor Name: | JOHN LACUNZA |
NPI Number: | 1235299975 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 01063881A |
Business Practice Address: | 5001 Us Highway 30 W Ste D Fort Wayne, IN - 468189701 |
Business Phone Number: | 2604321568 |
Business Fax Number: | 2604324969 |
Mailing Address: | Po Box 80070, FORT WAYNE |
State: | IN |
Postal Code: | 468980070 |
Phone Number: | 2604321568 |
Fax Number: | 2604324969 |
NPI Enumeration Date: | 12/11/2006 |
NPI Last Update Date: | 11/17/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2085B0100X |
License Number: | 01063881A |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Radiology |
Taxonomy Specialization: | Body Imaging |
Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |