Pogue, Lucas C

Pogue, Lucas C is an individual health care provider with primary practice located at 1401 Eastland Dr , Bloomington IL 61701-3552. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Pogue, Lucas C can be contacted via phone (309) 663-8311.

Contact Information

Primary practice address
1401 Eastland Dr Bloomington IL 61701-3552
Fax: (309) 661-3390
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036103017 Illinois
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036103017 Illinois

Profile Details

NPI number 1033195847
LBN Legal business name Pogue, Lucas C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2005
Last updated Mar 31st, 2023 - about 2 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 1033195847 NPPES
Illinois MEDICAID 036103017
Illinois Other 5715384

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