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1295583607
LUCAS JOHN SMITH
PROVIDENCE, RI
NPI
1295583607
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: RI LP06296)
Enumeration Date
2024-05-09
Last Update Date
2024-05-09
Business Address
LUCAS JOHN SMITH MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-793-2930
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Mailing Address
LUCAS JOHN SMITH MD
593 EDDY ST
PROVIDENCE, RI 02903-4923
Phone number: 401-793-2695
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