Individual
DR. JONATHAN LUCAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1805 WALLER ST, PORTSMOUTH, OH 45662-2945
(740) 353-4511
Mailing address
1805 WALLER ST, PORTSMOUTH, OH 45662-2945
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3621
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0492935
—
OH
Enumeration date
09/03/2006
Last updated
07/24/2008
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