Provider Demographics
NPI:1609845098
Name:LUCAS, ROBERT S (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:LUCAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5501 WILLIAMSON RD
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-1439
Mailing Address - Country:US
Mailing Address - Phone:540-362-1616
Mailing Address - Fax:540-362-8234
Practice Address - Street 1:5501 WILLIAMSON RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-1439
Practice Address - Country:US
Practice Address - Phone:540-362-1616
Practice Address - Fax:540-362-8234
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2007-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043731207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1467130OtherCIGNA
VACB0245OtherMEDICARE RAILROAD
VA394048OtherANTHEM
VACB0245OtherMEDICARE RAILROAD
VA1467130OtherCIGNA