Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 6821 | AL |
NPI | 1477583771 |
---|---|
Provider Name | John A Lucas III |
First Address | Nashville, TN 37232-0001 |
Second Address | Nashville, TN 37232-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 02/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009901495 | (05) | AL |
009937555 | (05) | AL |
051510346 | (05) | AL |
051510346 | BLUE CROSS (01) | AL |
051510347 | BLUE CROSS (01) | AL |
051518369 | BLUE CROSS (01) | AL |
160058392 | RAILROAD MEDICARE (01) | AL |