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Individual

MR. BARRY CLAUDE LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1199 PRINCE AVE, ATHENS, GA 30606-2797
(706) 475-3666
Mailing address
PO BOX 3209, INDIANAPOLIS, IN 46206-3209
(706) 475-3666

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN149716
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
046603632A
GA
05
046603632B
GA
05
046603632C
GA
01
P00277448
RAILROAD MEDICARE
GA
Enumeration date
05/11/2006
Last updated
01/08/2018
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