Healthcare Provider Details

I. General information

NPI: 1407843485
Provider Name (Legal Business Name): SCOTT K LUCAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1265 S UTICA AVE STE 300
TULSA OK
74104-4243
US

IV. Provider business mailing address

18708 OTTER CREEK DR
EDMOND OK
73012-4126
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax: 918-592-1021
Mailing address:
  • Phone: 405-990-4930
  • Fax: 405-758-5582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number11551
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number11551
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: