Provider Demographics
NPI:1245203868
Name:TUBBS, LUCAS J (DC)
Entity Type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:J
Last Name:TUBBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 W. 6TH
Mailing Address - Street 2:
Mailing Address - City:COLBY
Mailing Address - State:KS
Mailing Address - Zip Code:67701
Mailing Address - Country:US
Mailing Address - Phone:785-462-7236
Mailing Address - Fax:785-462-2170
Practice Address - Street 1:135 W 6TH ST
Practice Address - Street 2:
Practice Address - City:COLBY
Practice Address - State:KS
Practice Address - Zip Code:67701-2300
Practice Address - Country:US
Practice Address - Phone:785-462-7236
Practice Address - Fax:785-462-2170
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4807111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS660034Medicare ID - Type UnspecifiedGROUP
KS060954Medicare ID - Type UnspecifiedINDIVIDUAL