Individual
ROBERT RYAN LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
100 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5238
(740) 441-8058
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5238
(740) 441-8058
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APRN.CRNA.10983
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000282760
OHIO MEDICAID UNISON
OH
01
—
2983928
OH MEDICAID MOLINA
OH
05
—
2983928
—
OH
05
—
3810016105
—
WV
05
—
7100101310
—
KY
01
—
P00787210
RAILROAD MEDICARE
OH
Enumeration date
09/14/2009
Last updated
01/21/2021
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