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Individual

DR. SILAS EMMETT LUCAS III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657
Mailing address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
18085
SC
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
18085
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8157
MEDICARE PTAN
SC
05
T18530
SC
Enumeration date
04/27/2006
Last updated
02/19/2021
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