Lucas, Kevin David

Lucas, Kevin David is an individual health care provider with primary practice located at 4720 White Bear Pkwy , White Bear Lake MN 55110-3336. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Lucas, Kevin David can be contacted via phone (651) 426-2747.

Contact Information

Primary practice address
4720 White Bear Pkwy White Bear Lake MN 55110-3336
Phone: (651) 426-2747
Fax: (651) 426-9838
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X LD2695000 Minnesota

Profile Details

NPI number 1407848427
LBN Legal business name Lucas, Kevin David
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 16th, 2005
Last updated Jul 8th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407848427 NPPES
Minnesota Other 22-01733 MEDICA
Minnesota Other HP27080 MEDICA
Minnesota Other P00116310 MEDICA
Minnesota Other 22-02780 MEDICA
Minnesota Other 244R0LU MEDICA
Minnesota Other 965401019270 MEDICA

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