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Individual

DR. EDDY LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
0427571
KS
2085N0700X
Neuroradiology Physician
0427571
KS
2085P0229X
Pediatric Radiology Physician
0427571
KS
2085R0202X
Diagnostic Radiology Physician
Primary
0427571
KS
2085R0203X
Therapeutic Radiology Physician
0427571
KS
2085R0204X
Vascular & Interventional Radiology Physician
0427571
KS
2085U0001X
Diagnostic Ultrasound Physician
0427571
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100197900A
OK
05
100313220H
KS
05
1205832698
MO
01
P00628030
RR MEDICARE
KS
Enumeration date
06/22/2005
Last updated
10/31/2011
Update your record

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