Individual
DR. TODD LEROY LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(706) 354-5770
(706) 354-5769
Mailing address
PO BOX 5719, ATHENS, GA 30604-5719
(706) 354-5770
(706) 354-5769
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
110287
MO
207P00000X
Emergency Medicine Physician
Primary
2021007445
MO
207P00000X
Emergency Medicine Physician
MD 2009-0058
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
71229558
—
NM
Enumeration date
08/31/2006
Last updated
03/03/2021
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