Provider Demographics
NPI:1548471402
Name:MCLUCAS, PATRICK BERNARD (DO)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:BERNARD
Last Name:MCLUCAS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 LOGAN BLVD
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16602-4029
Mailing Address - Country:US
Mailing Address - Phone:814-943-9879
Mailing Address - Fax:814-943-1808
Practice Address - Street 1:1890 N JUNIATA ST
Practice Address - Street 2:
Practice Address - City:HOLLIDAYSBURG
Practice Address - State:PA
Practice Address - Zip Code:16648-1997
Practice Address - Country:US
Practice Address - Phone:814-693-7822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2019-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014166208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice