Organization
VINEYARD PRIMARY CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMY LUKETT MD (OWNER)
(270) 240-2305
Entity
Organization
Contact information
Practice address
2851 NEW HARTFORD RD, SUITE A, OWENSBORO, KY 42303-1320
(270) 240-2305
Mailing address
2851 NEW HARTFORD RD, SUITE A, OWENSBORO, KY 42303-1320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
06/01/2015
Last updated
02/05/2018
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