Provider Demographics
NPI:1710481700
Name:WRIGHT, LUCAS ANDREW
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:ANDREW
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 PINEHURST DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40324-9596
Mailing Address - Country:US
Mailing Address - Phone:859-533-6908
Mailing Address - Fax:
Practice Address - Street 1:129 STONE TRACE DR
Practice Address - Street 2:
Practice Address - City:MT STERLING
Practice Address - State:KY
Practice Address - Zip Code:40353-9386
Practice Address - Country:US
Practice Address - Phone:859-737-9900
Practice Address - Fax:859-737-0050
Is Sole Proprietor?:No
Enumeration Date:2018-03-22
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY05429208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program