Individual
JOSEPH LUCKOSE CHATHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 S POWER RD, SUITE 101, MESA, AZ 85206-5205
(480) 981-2010
(480) 981-1771
Mailing address
221 S POWER RD, SUITE 101, MESA, AZ 85206-5205
(480) 981-2010
(480) 981-1771
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
15177
AZ
207RI0011X
Interventional Cardiology Physician
Primary
15177
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0626556
AETNA
AZ
05
—
224634
—
AZ
01
—
AZ0015400
BCBS
AZ
Enumeration date
07/14/2006
Last updated
01/07/2015
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