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Contact Information

ETHAN D LUCAS
500 BARRETT THRIVE
MALDEN, MO63863
 Phone: 573-888-5925
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Other Service Providers

175T00000X
Indicates primary specialty

NPI Profile & details for ETHAN D LUCAS · (Male)

NPI # 1992506554
Status Active
Credentials
Entity Individual
Enumeration date 03/20/2025
Last updated 03/20/2025 - More than a year ago
Sole proprietor 1 No
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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