Individual
DR. LUCAS JOSEPH SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
109 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-3489
(419) 294-2791
Mailing address
109 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-3489
(419) 294-2791
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
2611
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000115406
BLUE CROSS
OH
01
—
1033223284
NPI
OH
05
—
2795097
—
OH
01
—
5871514
AETNA
OH
Enumeration date
08/17/2006
Last updated
01/11/2016
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