Individual
DIVINI LUCCIONI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
76 SHADY LANE DR, SLIDELL, LA 70461-1538
(504) 444-1668
(504) 444-1668
Mailing address
76 SHADY LANE DR, SLIDELL, LA 70461-1538
(504) 444-1668
(504) 444-1668
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
15213R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1163082
—
LA
Enumeration date
01/31/2006
Last updated
05/18/2011
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