Provider Demographics
NPI:1952537532
Name:LUCAS, DOUGLAS E (DO)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:E
Last Name:LUCAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1 MERCADO ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-7306
Mailing Address - Country:US
Mailing Address - Phone:970-247-5362
Mailing Address - Fax:970-259-6045
Practice Address - Street 1:800 FLEMING ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-3528
Practice Address - Country:US
Practice Address - Phone:828-698-4318
Practice Address - Fax:828-698-4322
Is Sole Proprietor?:No
Enumeration Date:2009-06-09
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-02333207XX0004X, 207X00000X
390200000X
CODR.0054828207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0004XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryFoot and Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO21109257Medicaid