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Individual

DR. LUCAS JOHN PAVLOVICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
801 GORMAN AVE, ELKINS, WV 26241-3147
(304) 636-3300
Mailing address
812 GORMAN AVE, ELKINS, WV 26241-3181
(304) 636-3300

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19751
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001722346
BC/BS NUMBER
WV
05
0098428000
WV
01
1659391472
TYPE II NPI
01
5110270001
MEDICARE DME
WV
Enumeration date
01/20/2006
Last updated
10/02/2024
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