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Individual

DR. MARK S. LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
2395 TECH DR, STE 4, BETTENDORF, IA 52722
(563) 332-9888
(563) 332-9898
Mailing address
2395 TECH DR, STE 4, BETTENDORF, IA 52722
(563) 332-9888
(563) 332-9898

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
00445
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0048595
IA
01
27214
MEDICARE SUPPLIER #
IA
Enumeration date
05/04/2006
Last updated
02/27/2008
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