Individual
KENNETH WILSON LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2205 N PARHAM RD, RICHMOND, VA 23229-3161
(804) 270-2150
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
(804) 217-7991
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101027078
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5630703
—
VA
Enumeration date
02/17/2006
Last updated
04/06/2018
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