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NPI Code Detail

MEDICARE: DR. JAY H LUCAS M.D.

MEDICARE: DR. JAY H LUCAS M.D.
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
1208200000XPlastic Surgery PhysicianMD0000036890TN

General Provider Information

NPI Number : 1447301270
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAY H LUCAS M.D.
Provider Business Mailing Address
First Line : 280 FORT SANDERS WEST BLVD 112
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-3352
Country : US
Telephone Number : 865-218-6210
Fax Number : 865-218-6211
Provider Business Practice Location Address
First Line : 280 FORT SANDERS WEST BLVD
Second Line : STE 112
City : KNOXVILLE
State : TN
Zip : 37922-3352
Country : US
Telephone Number : 865-218-6210
Fax Number : 865-218-6211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2007
Last Update Date : 09/08/2016

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