Individual
JASON LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 605-2800
(404) 351-5983
Mailing address
95 COLLIER RD NW, SUITE 2055, ATLANTA, GA 30309-1796
(404) 605-2800
(404) 351-5983
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003668
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003109887A
—
GA
Enumeration date
05/09/2011
Last updated
06/21/2011
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