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NPI Code Detail

MEDICARE: DR. TODD JEFFERSON LUCAS MD

MEDICARE: DR. TODD JEFFERSON LUCAS MD
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
1208600000XSurgery Physician39634TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184623258
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TODD JEFFERSON LUCAS MD
Provider Business Mailing Address
First Line : 1265 E COLLEGE ST
Second Line : SUITE 9
City : PULASKI
State : TN
Zip : 38478-4541
Country : US
Telephone Number : 931-424-9069
Fax Number : 931-424-9079
Provider Business Practice Location Address
First Line : 1265 E COLLEGE ST
Second Line : SUITE 9
City : PULASKI
State : TN
Zip : 38478-4541
Country : US
Telephone Number : 931-424-9069
Fax Number : 931-424-9079
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/20/2005
Last Update Date : 07/29/2008

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Directions to “ DR. TODD JEFFERSON LUCAS MD” Practice Location

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