Provider Demographics
NPI:1861032344
Name:WRIGHT, LUCAS ADAM (MA)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:ADAM
Last Name:WRIGHT
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 LYNNWOOD ST
Mailing Address - Street 2:
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-2919
Mailing Address - Country:US
Mailing Address - Phone:580-931-3441
Mailing Address - Fax:580-924-6775
Practice Address - Street 1:2425 W UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-2942
Practice Address - Country:US
Practice Address - Phone:580-924-7330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-13
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator