Organization
E MICHAEL LUCERO, MD PC
Active
Organization
E MICHAEL LUCERO, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARCY WILKINSON (PRACTICE MANAGER)
(602) 667-6640
Entity
Organization
Contact information
Practice address
2222 E HIGHLAND AVE, SUITE 425, PHOENIX, AZ 85016-4872
(602) 667-6640
Mailing address
2222 E HIGHLAND AVE, SUITE 425, PHOENIX, AZ 85016-4872
(602) 667-6640
Taxonomy
Speciality
Code
Description
License number
State
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
21440
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
135378
—
AZ
Enumeration date
09/28/2012
Last updated
09/28/2012
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