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NPI Code Detail

MEDICARE: DR. OWEN H LUCAS JR. MD

MEDICARE: DR. OWEN H LUCAS JR. 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
12083X0100XOccupational Medicine Physician01023934AIN

General Provider Information

NPI Number : 1598757932
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. OWEN H LUCAS JR. MD
Provider Business Mailing Address
First Line : 5783 KILLDEER DR
Second Line :
City : CARMEL
State : IN
Zip : 46033-8958
Country : US
Telephone Number : 317-587-0973
Fax Number :
Provider Business Practice Location Address
First Line : 8177 CLEARVISTA PKWY
Second Line : SUITE B
City : INDIANAPOLIS
State : IN
Zip : 46256-1662
Country : US
Telephone Number : 317-621-7808
Fax Number : 317-621-7805
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 07/08/2007

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