Provider Demographics
NPI:1407843485
Name:LUCAS, SCOTT K (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:K
Last Name:LUCAS
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Gender:
Credentials:MD
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Mailing Address - Street 1:18708 OTTER CREEK DR
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-4126
Mailing Address - Country:US
Mailing Address - Phone:405-990-4930
Mailing Address - Fax:405-758-5582
Practice Address - Street 1:1265 S UTICA AVE STE 300
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-4243
Practice Address - Country:US
Practice Address - Phone:918-592-0999
Practice Address - Fax:918-592-1021
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK11551208600000X, 208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD34965Medicare UPIN