Individual
SHELBY LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
908 N ROCKFORD ROAD, SUITE A, ARDMORE, OK 73401-2541
(580) 226-7771
(580) 226-7788
Mailing address
908 N ROCKFORD ROAD, SUITE A, ARDMORE, OK 73401-2541
(580) 226-7771
(580) 226-7788
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1325
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200043090B
—
OK
Enumeration date
08/05/2006
Last updated
08/10/2011
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