Individual
THOMAS JOHN LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(703) 369-8337
Mailing address
20010 CENTURY BLVD, STE 200, GERMANTOWN, MD 20874-1115
(240) 686-2300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101243613
VA
207P00000X
Emergency Medicine Physician
MD436552
PA
Other
Enumeration date
03/14/2007
Last updated
11/02/2012
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