Provider Demographics
NPI:1881676971
Name:LUCAS, MARTIN K (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:K
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MARTIN
Other - Middle Name:
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 30976
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-0976
Mailing Address - Country:US
Mailing Address - Phone:406-238-6290
Mailing Address - Fax:406-238-6961
Practice Address - Street 1:1315 GOLDEN VALLEY CIR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6746
Practice Address - Country:US
Practice Address - Phone:406-238-6290
Practice Address - Fax:406-238-6961
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9626207RH0003X
WY6459A207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY115662400Medicaid
MT810511516009OtherEBMS
MT0045448Medicaid
WY310594OtherBLUE CROSS
MT000092621OtherBLUE CROSS
MT810511516009OtherEBMS
WY115662400Medicaid
E85640Medicare UPIN
MT900003319Medicare ID - Type UnspecifiedMEDICARE RAILROAD
WY900003320Medicare ID - Type UnspecifiedMEDICARE RAILROAD