Healthcare Provider Details

I. General information

NPI: 1326026261
Provider Name (Legal Business Name): WILLIAM MATTHEW LUCAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/01/2006
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 7TH ST BLDG 700700-A
ROBINS AFB GA
31098-2227
US

IV. Provider business mailing address

655 7TH ST BLDG 700700-A
ROBINS AFB GA
31098-2227
US

V. Phone/Fax

Practice location:
  • Phone: 478-327-7850
  • Fax:
Mailing address:
  • Phone: 478-327-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD127276
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberMD126276
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD126276
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: