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NPI Code Detail

MEDICARE: MARK J LUCARELLI MD

MEDICARE: MARK J LUCARELLI MD
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
1207WX0200XOphthalmic Plastic and Reconstructive Surgery Physician37378WI
2207W00000XOphthalmology Physician37378WI

General Provider Information

NPI Number : 1992771034
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK J LUCARELLI MD
Provider Business Mailing Address
First Line : 7974 UW HEALTH CT
Second Line :
City : MIDDLETON
State : WI
Zip : 53562-5531
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2880 UNIVERSITY AVE
Second Line :
City : MADISON
State : WI
Zip : 53705-3644
Country : US
Telephone Number : 608-263-7171
Fax Number : 608-265-8060
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2006
Last Update Date : 01/12/2021

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Directions to “ MARK J LUCARELLI MD” Practice Location

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