Individual
MR. LUCAS JAY SHAFFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3555 OLENTANGY RIVER RD, SUITE 2001, COLUMBUS, OH 43214-3912
(614) 533-5500
Mailing address
5350 FRANTZ RD, DUBLIN, OH 43016-4259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.003714
OH
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0080516
—
OH
Enumeration date
02/11/2008
Last updated
01/25/2022
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