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Individual

ROBERTA WARD LUCAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
595 E CROSSVILLE RD, STE 100, ROSWELL, GA 30075-5818
(770) 645-2250
(770) 643-5850
Mailing address
595 E CROSSVILLE RD, STE 100, ROSWELL, GA 30075-5818
(770) 645-2250
(770) 643-5850

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
038040
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000580016E
GA
Enumeration date
07/07/2006
Last updated
01/28/2015
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