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NPI Code Detail

MEDICARE: JOHN LACUNZA M.D.

MEDICARE: JOHN LACUNZA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12085R0202XDiagnostic Radiology Physician01063881AIN
22085B0100XBody Imaging Physician01063881AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235299975
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN LACUNZA M.D.
Provider Business Mailing Address
First Line : 1100 REID PKWY
Second Line :
City : RICHMOND
State : IN
Zip : 47374-1157
Country : US
Telephone Number : 765-983-3000
Fax Number :
Provider Business Practice Location Address
First Line : 5001 US HIGHWAY 30 W STE D
Second Line :
City : FORT WAYNE
State : IN
Zip : 46818-9701
Country : US
Telephone Number : 260-432-1568
Fax Number : 260-432-4969
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2006
Last Update Date : 03/25/2026

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Directions to “ JOHN LACUNZA M.D.” Practice Location

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