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Individual

MR. JAMES R LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
111 W HOSPITAL DR, WEST COLUMBIA, SC 29169-3405
(803) 796-8515
(803) 796-8516
Mailing address
9735 KINCEY AVE, SUITE 201, HUNTERSVILLE, NC 28078-9118
(704) 414-2870
(704) 414-2860

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MPA1695PA
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1469PA
SC
Enumeration date
10/04/2011
Last updated
03/31/2015
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