MEDICARE: DR. CHRISTOPHER CHARLES LUCAS 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
1	207Q00000X	Family Medicine Physician	ME 72359	FL
2	2083A0100X	Aerospace Medicine Physician	ME 72359	FL
3	2083X0100X	Occupational Medicine Physician	ME 72359	FL

General Provider Information

NPI Number	:	1356311864
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER CHARLES LUCAS M.D.

Provider Business Mailing Address
First Line	:	USS CARL VINSON
Second Line	:	CVN 70
City	:	FPO
State	:	AE
Zip	:	09566-2840
Country	:	US
Telephone Number	:	757-534-0703
Fax Number	:

Provider Business Practice Location Address
First Line	:	USS CARL VINSON
Second Line	:	CVN 70
City	:	FPO
State	:	AE
Zip	:	09566-2840
Country	:	US
Telephone Number	:	757-534-0703
Fax Number	:

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

Provider Enumeration Date	:	01/25/2006
Last Update Date	:	03/26/2009

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