| Lucas Family Medicine Pllc | |
|
473 N 12th St Middlesboro KY 40965-1133 | |
| (423) 444-3368 | |
| Not Available |
| Full Name | Lucas Family Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 473 N 12th St, Middlesboro, Kentucky |
| Authorized Official Name and Position | Jonathon Edward Lucas (CO-OWNER/ MANAGER) |
| Authorized Official Contact | 4234443368 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lucas Family Medicine Pllc 403 Sharpes Woods Rd Pineville KY 40977-7539 Ph: (423) 444-3368 | Lucas Family Medicine Pllc 473 N 12th St Middlesboro KY 40965-1133 Ph: (423) 444-3368 |
| NPI Number | 1932899176 |
|---|---|
| Provider Enumeration Date | 05/10/2023 |
| Last Update Date | 01/31/2024 |
| Medicare PECOS PAC ID | 5395106025 |
|---|---|
| Medicare Enrollment ID | O20230727003666 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932899176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Elizabeth Lucas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346524154 PECOS PAC ID: 8729209812 Enrollment ID: I20170517001481 |
| Provider Name | Dustin Michael Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851075071 PECOS PAC ID: 9234576497 Enrollment ID: I20240322003133 |
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