Individual
JAY LUKE LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1540 AMERICAN DR, FLORENCE, SC 29505-6072
(843) 317-9999
(843) 317-1996
Mailing address
1540 AMERICAN DRIVE, FLORENCE, SC 29505
(843) 317-9999
(843) 317-1996
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9934
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02-0654505
BLUE CROSS BLUE SHIELD
SC
01
—
10-00541
CAROLINA CARE PLAN
RI
05
—
GP3611
—
SC
Enumeration date
05/17/2006
Last updated
01/22/2020
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