Individual
ELIZABETH LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
241 CLARKSON RD, SUITE 103, ELLISVILLE, MO 63011-2219
(636) 256-4941
(636) 256-6530
Mailing address
241 CLARKSON RD, SUITE 103, ELLISVILLE, MO 63011-2219
(636) 256-4941
(636) 256-6530
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2004012245
MO
207R00000X
Internal Medicine Physician
2004011245
MO
208000000X
Pediatrics Physician
2004011245
MO
208M00000X
Hospitalist Physician
2004011245
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209119601
—
MO
Enumeration date
12/27/2006
Last updated
01/13/2020
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