Provider Demographics
NPI:1811269822
Name:ALLMON, LUCAS (APA-C)
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:ALLMON
Suffix:
Gender:M
Credentials:APA-C
Other - Prefix:
Other - First Name:LUC
Other - Middle Name:
Other - Last Name:ALLMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 13253
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-4023
Mailing Address - Country:US
Mailing Address - Phone:410-860-4506
Mailing Address - Fax:
Practice Address - Street 1:1675 WOODBROOKE DR
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-8502
Practice Address - Country:US
Practice Address - Phone:410-749-4154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-07
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1102049363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1102049OtherNCCPA