Provider Demographics
NPI:1720064959
Name:LUCAS, ASHLEY ADAMS (MD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:ADAMS
Last Name:LUCAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-526-0011
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:12525 PERKINS RD
Practice Address - Street 2:SUITE C
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-1907
Practice Address - Country:US
Practice Address - Phone:225-769-2003
Practice Address - Fax:225-767-3055
Is Sole Proprietor?:No
Enumeration Date:2005-12-20
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA023416208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1480568Medicaid
LAH27617Medicare UPIN
LA5H873CQ60Medicare PIN
LA5H873D279Medicare PIN
LA4M532D279Medicare PIN
LA5H873BD11Medicare PIN