Healthcare Provider Details

I. General information

NPI: 1861987935
Provider Name (Legal Business Name): LUCAS MCKEAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2018
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 WELLNESS WAY
FINDLAY OH
45840-9547
US

IV. Provider business mailing address

3401 WELLNESS WAY
FINDLAY OH
45840-9547
US

V. Phone/Fax

Practice location:
  • Phone: 419-429-6473
  • Fax: 419-424-0926
Mailing address:
  • Phone: 419-429-6473
  • Fax: 419-424-0926

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35.150889
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: