Individual
KEVIN R LUSK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 S MAIN ST, FERDINAND, IN 47532-9534
(812) 367-1906
(812) 367-2487
Mailing address
PO BOX 1028, JASPER, IN 47547-1028
(812) 996-0410
(812) 996-8497
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01048988A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200441670B
—
IN
Enumeration date
09/28/2006
Last updated
07/07/2014
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