Individual
MARK LEROY LUKENS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1331 N ELM ST STE 200, GREENSBORO, NC 27401-6304
(336) 274-6682
(336) 274-8097
Mailing address
PO BOX 85378, CHICAGO, IL 60689-5378
(336) 274-6682
(336) 274-8097
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
98-00620
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11643
BCBSNC
NC
01
—
300098800
RAILROAD MEDICARE
NC
05
—
8911643
—
NC
01
—
NC4231E
MEDICARE ID TYPE UNSPECIFIED
—
Enumeration date
01/09/2006
Last updated
10/01/2025
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