Provider Demographics
NPI:1891281671
Name:LUCAS, LINDSEY ERIN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:ERIN
Last Name:LUCAS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 MELLWOOD AVE APT 301
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206-1063
Mailing Address - Country:US
Mailing Address - Phone:702-419-5110
Mailing Address - Fax:
Practice Address - Street 1:10639 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40272-4349
Practice Address - Country:US
Practice Address - Phone:502-933-9200
Practice Address - Fax:502-736-4487
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY2126DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program