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Individual

JOHN R LUCAS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1906 BELLEVIEW AVE SE, ROANOKE, VA 24014-1838
(540) 981-7000
(540) 981-9550
Mailing address
PO BOX 2080, KILMARNOCK, VA 22482-2080
(804) 435-3508

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102201280
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
005874904
VA
05
005874912
VA
05
010049024
VA
05
010049628
VA
05
010093619
VA
05
010108675
VA
Enumeration date
03/31/2006
Last updated
05/20/2008
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