Individual
DR. MATTHEW DANIEL LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-5446
(601) 815-5446
Mailing address
727 LINDENWOOD CIR W, ORMOND BEACH, FL 32174-4664
(516) 368-4448
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
T-5255
MS
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/01/2024
Last updated
07/01/2024
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