Provider Demographics
NPI:1932301900
Name:LUCAS, JAMES RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:RICHARD
Last Name:LUCAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343800 E 820 RD
Mailing Address - Street 2:
Mailing Address - City:AGRA
Mailing Address - State:OK
Mailing Address - Zip Code:74824-8419
Mailing Address - Country:US
Mailing Address - Phone:918-375-2547
Mailing Address - Fax:918-375-2547
Practice Address - Street 1:202 BROADWAY AVE.
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:OK
Practice Address - Zip Code:74026
Practice Address - Country:US
Practice Address - Phone:918-377-2237
Practice Address - Fax:918-377-2239
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-01
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK8941208D00000X
TXJ3843208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD42600Medicare UPIN