Provider Demographics
NPI:1598757932
Name:LUCAS, OWEN H JR (MD)
Entity Type:Individual
Prefix:DR
First Name:OWEN
Middle Name:H
Last Name:LUCAS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5783 KILLDEER DR
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8958
Mailing Address - Country:US
Mailing Address - Phone:317-587-0973
Mailing Address - Fax:
Practice Address - Street 1:8177 CLEARVISTA PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46256-1662
Practice Address - Country:US
Practice Address - Phone:317-621-7808
Practice Address - Fax:317-621-7805
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IN01023934A2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D69780Medicare UPIN