MEDICARE: MEGHAN ASHLEIGH LUCAS

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
1	363AS0400X	Surgical Physician Assistant
2	363AS0400X	Surgical Physician Assistant	11266	AZ
3	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1326521063
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN ASHLEIGH LUCAS

Provider Business Mailing Address
First Line	:	2400 S AVENUE A
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-7127
Country	:	US
Telephone Number	:	928-344-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	2460 S PARKVIEW LOOP STE 203
Second Line	:
City	:	YUMA
State	:	AZ
Zip	:	85364-5358
Country	:	US
Telephone Number	:	928-336-2619
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2018
Last Update Date	:	10/15/2025

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Directions to “ MEGHAN ASHLEIGH LUCAS ” Practice Location

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