Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 35042564 | OH |
NPI | 1053310037 |
---|---|
Provider Name | Janet M Lucas |
First Address | Columbus, OH 43222-1553 |
Second Address | Columbus, OH 43222-1553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2005 |
Last Update Date | 28/01/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0483721 | (05) | OH |
C02099 | (02) | OH |