Provider Demographics
NPI:1427495092
Name:LUCAS, JOSHUA MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MICHAEL
Last Name:LUCAS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1250 RALSTON AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-5311
Mailing Address - Country:US
Mailing Address - Phone:419-782-8332
Mailing Address - Fax:419-782-6855
Practice Address - Street 1:1250 RALSTON AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-5311
Practice Address - Country:US
Practice Address - Phone:419-782-8332
Practice Address - Fax:419-782-6855
Is Sole Proprietor?:No
Enumeration Date:2013-05-22
Last Update Date:2023-11-03
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Provider Licenses
StateLicense IDTaxonomies
TXQ1445207Q00000X
OH35128152207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH469900Medicare PIN