Provider Demographics
NPI:1003313438
Name:PHILIPP, LUCAS RYAN (MD)
Entity type:Individual
Prefix:DR
First Name:LUCAS
Middle Name:RYAN
Last Name:PHILIPP
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:19550 E 39TH ST S STE 105
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1926
Mailing Address - Country:US
Mailing Address - Phone:816-350-4215
Mailing Address - Fax:816-350-4220
Practice Address - Street 1:19550 E 39TH ST S STE 105
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1926
Practice Address - Country:US
Practice Address - Phone:816-350-4215
Practice Address - Fax:816-350-4220
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2025-11-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2025047637207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery