Provider Demographics
NPI:1669485694
Name:LUCAS, AARON E (MD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:E
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 1:1412 SAINT JAMES CT
Mailing Address - Street 2:LOUISVILLE
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40208-2127
Mailing Address - Country:US
Mailing Address - Phone:502-366-8825
Mailing Address - Fax:502-366-0044
Practice Address - Street 1:4402 CHURCHMAN AVE
Practice Address - Street 2:LOUISVILLE
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40215-1190
Practice Address - Country:US
Practice Address - Phone:502-366-8825
Practice Address - Fax:502-366-0044
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY17917208600000X, 208G00000X
IN32579208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100004400Medicaid
KY1048808OtherPASSPORT
KY64179179Medicaid
KY000000051437OtherANTHEM FACET
KY2432227000OtherPASSPORT ADVTAGE
IN195800AMedicare ID - Type UnspecifiedCLARK CO
KYC69165Medicare UPIN
KY1048808OtherPASSPORT
KY2432227000OtherPASSPORT ADVTAGE
KY330003714Medicare ID - Type UnspecifiedRAILROAD MEDICARE