Healthcare Provider Details

I. General information

NPI: 1730704230
Provider Name (Legal Business Name): LUCAS S REITZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2020
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 4TH ST SE
ROCHESTER MN
55904-4717
US

IV. Provider business mailing address

1650 4TH ST SE
ROCHESTER MN
55904-4717
US

V. Phone/Fax

Practice location:
  • Phone: 507-529-6600
  • Fax:
Mailing address:
  • Phone: 507-529-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number76446
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number8792
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: