Individual
MR. JOHN R LUCKASEN
Active
Individual
MR. JOHN R LUCKASEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
12194
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001967
BLUE SHIELD
SD
01
—
00686
BLUE SHIELD
NE
01
—
0300003
UNITED HEALTH CARE
NE
05
—
0918649
—
IA
01
—
139381XX
PREFERRED CARE
NE
05
—
47062325613
—
NE
01
—
501880
BLUE SHIELD
PA
05
—
7787680
—
SD
01
—
91864
BLUE SHIELD
IA
Enumeration date
06/13/2005
Last updated
07/13/2026
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