Provider Demographics
NPI:1639399199
Name:PITTS, LUCAS (MD)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:
Last Name:PITTS
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 1:3901 RAINBOW BLVD, MAILSTOP 3007
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160
Mailing Address - Country:US
Mailing Address - Phone:913-588-6046
Mailing Address - Fax:913-588-4098
Practice Address - Street 1:3901 RAINBOW BLVD, MAILSTOP 3007
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160
Practice Address - Country:US
Practice Address - Phone:913-588-6046
Practice Address - Fax:913-588-4098
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2014-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS946407207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine