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Individual

GORDON H. LUCAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
90 HIGHWAY 91 SOUTH, DILLON, MT 59725-3516
(406) 683-3000
Mailing address
PO BOX 34940, SEATTLE, WA 98124-1940
(503) 372-2740
(503) 372-2754

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
29790
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
4302037
MT
Enumeration date
07/12/2006
Last updated
07/08/2007
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