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Organization

SOUTHEAST SURGICAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TODD JEFFERSON LUCAS MD (MD/PRESIDENT)
(931) 424-9069
Entity
Organization

Contact information

Practice address
1265 E COLLEGE ST, SUITE 9, PULASKI, TN 38478-4541
(931) 424-9069
(931) 424-9079
Mailing address
1265 E COLLEGE ST, SUITE 9, PULASKI, TN 38478-4541
(931) 424-9069
(931) 424-9079

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
39634
TN

Other

Enumeration date
05/03/2006
Last updated
08/01/2008
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