Provider Demographics
NPI:1154633170
Name:THOMPSON, LUCAS (MD)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:3901 RAINBOW BLVD
Mailing Address - Street 2:MS4010 FAM MED RESIDENCY OFFICE
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-2937
Mailing Address - Country:US
Mailing Address - Phone:913-588-1902
Mailing Address - Fax:913-588-1951
Practice Address - Street 1:3901 RAINBOW BLVD
Practice Address - Street 2:MS4010 FAM MED RESIDENCY OFFICE
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-2937
Practice Address - Country:US
Practice Address - Phone:913-588-1902
Practice Address - Fax:913-588-1951
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-07
Last Update Date:2010-07-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS94-07568207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine