Individual
KELLIE LYN LUCAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 873-2710
Mailing address
1978 INDUSTRIAL BLVD, HOUMA, LA 70363-7055
(985) 873-2710
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
95882
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/08/2020
Last updated
08/31/2023
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