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Individual

DR. STEPHEN LUKE GRUPKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MS

Contact information

Practice address
3601 21ST ST, LUBBOCK, TX 79410-1229
(806) 790-0399
Mailing address
2215 NASHVILLE AVE # MS 106, LUBBOCK, TX 79410-1105
(806) 725-5844
(859) 257-8902

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
49206
KY
207T00000X
Neurological Surgery Physician
Primary
S9137
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1K4394
MEDICARE
TX
05
40209512
NM
05
7100245890
KY
Enumeration date
05/12/2009
Last updated
01/20/2022
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