Provider Demographics
NPI:1750473740
Name:LUCAS, JAMES R (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:LUCAS
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Gender:M
Credentials:MD
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Mailing Address - Street 1:67-1123 MAMALAHOA HWY
Mailing Address - Street 2:SUITE 130
Mailing Address - City:KAMUELA
Mailing Address - State:HI
Mailing Address - Zip Code:96743-8451
Mailing Address - Country:US
Mailing Address - Phone:808-885-9170
Mailing Address - Fax:808-887-1787
Practice Address - Street 1:67-1123 MAMALAHOA HWY
Practice Address - Street 2:SUITE 130
Practice Address - City:KAMUELA
Practice Address - State:HI
Practice Address - Zip Code:96743-8451
Practice Address - Country:US
Practice Address - Phone:808-885-9170
Practice Address - Fax:808-887-1787
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2012-06-15
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Provider Licenses
StateLicense IDTaxonomies
HI9393207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07823101Medicaid
HI0000206888OtherHMSA
HIF10876Medicare UPIN
HI07823101Medicaid