Individual
MRS. CELESTE CHILDRESS LUKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2495 SHREVEPORT HWY, PINEVILLE, LA 71360-4044
(318) 473-0010
Mailing address
ALEXANDRIA VA HEALTH CARE SYSTEM, 2495 SHREVEPORT HIGHWAY, PINEVILLE, LA 71360-4044
(318) 473-0010
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
12539R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1541184
—
LA
01
—
180034882
RAILROAD MEDICARE
LA
01
—
185374602
UNITED HEALTHCARE
LA
05
—
1948691
—
LA
01
—
721418139
STATE GROUP BENEFITS
LA
01
—
9903808
GEHA
LA
Enumeration date
11/03/2005
Last updated
07/18/2024
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