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1134359649 NPI number — BROOKE ANN LUCAS M.D.

NPI Number: 1134359649
Health Care Provider/Practitioner: BROOKE ANN LUCAS M.D.

Information about “1134359649” NPI (BROOKE ANN LUCAS M.D.) exists in 1134359649 in HTML format HTML  |  1134359649 in plain Text format TXT  |  1134359649 in PDF (Portable Document Format) PDF  |  1134359649 in an XML format XML  formats.

NPI Number : 1134359649 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1134359649",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "LUCAS",
    "FirstName": "BROOKE",
    "MiddleName": "ANN",
    "NamePrefix": "MRS.",
    "NameSuffix": null,
    "Credential": "M.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "REICH",
    "OtherFirstName": "BROOKE",
    "OtherMiddleName": "ANN",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "30701 WOODWARD AVE. SUITE S-200",
    "SecondLineMailingAddress": "WOMEN FIRST OB/GYN CENTER",
    "MailingAddressCityName": "ROYAL OAK",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48073",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "248-584-7600",
    "MailingAddressFaxNumber": "248-584-7606",
    "FirstLinePracticeLocationAddress": "30701 WOODWARD AVE. SUITE S-200",
    "SecondLinePracticeLocationAddress": "WOMEN FIRST OB/GYN CENTER",
    "PracticeLocationAddressCityName": "ROYAL OAK",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48073",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "248-584-7600",
    "PracticeLocationAddressFaxNumber": "248-584-7606",
    "EnumerationDate": "07/17/2009",
    "LastUpdateDate": "11/13/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207V00000X",
        "TaxonomyName": "Obstetrics & Gynecology Physician",
        "LicenseNumber": "4301094784",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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