Provider Demographics
NPI:1114039823
Name:MICHAEL L. LACCHEO, M.D., P.A.
Entity Type:Organization
Organization Name:MICHAEL L. LACCHEO, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:LEWIS
Authorized Official - Last Name:LACCHEO
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:785-271-6000
Mailing Address - Street 1:1119 SW GAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66604-1999
Mailing Address - Country:US
Mailing Address - Phone:785-271-6000
Mailing Address - Fax:785-271-6321
Practice Address - Street 1:1119 SW GAGE BLVD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66604-1999
Practice Address - Country:US
Practice Address - Phone:785-271-6000
Practice Address - Fax:785-271-6321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS19586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty