Individual
DOUGLAS J LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
6309 E BAYWOOD AVE, MESA, AZ 85206-1744
(480) 325-3801
(480) 325-3805
Mailing address
PO BOX 13550, MESA, AZ 85216-3550
(480) 325-3801
(480) 325-3805
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN101467
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
922931
—
AZ
Enumeration date
09/14/2006
Last updated
01/17/2014
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