Provider Demographics
NPI:1346865136
Name:LUCAS, VIRGINIA HAMILTON BEHLEN (DMD)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:HAMILTON BEHLEN
Last Name:LUCAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1754 GOVERNMENT ST.
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36604
Mailing Address - Country:US
Mailing Address - Phone:251-471-1516
Mailing Address - Fax:
Practice Address - Street 1:1754 GOVERNMENT ST.
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36604
Practice Address - Country:US
Practice Address - Phone:251-471-1516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-08
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program