Individual
JASON LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2300 E 30TH ST BLDG D, STE 101, FARMINGTON, NM 87401-8990
(505) 326-1400
(505) 327-3474
Mailing address
2300 E 30TH ST BLDG D, STE 101, FARMINGTON, NM 87401-8990
(505) 326-1400
(505) 327-3474
Taxonomy
Speciality
Code
Description
License number
State
207XX0801X
Orthopaedic Trauma Physician
Primary
A127504
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00NM009P18
BCBS
NM
05
—
26220555
—
NM
01
—
A-1275-04
NM MEDICAL LIS
NM
Enumeration date
11/30/2005
Last updated
05/06/2008
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