Individual
DR. VINCENT C LUSCO III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4402 CHURCHMAN AVE, STE 202, LOUISVILLE, KY 40215-3101
(502) 366-1090
(502) 366-1564
Mailing address
100 E LIBERTY ST STE 800, LOUISVILLE, KY 40202-1428
(502) 366-1090
(502) 366-1564
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
34952
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000289651
ANTHEM
KY
05
—
200397600
—
IN
01
—
50001240
PASSPORT
KY
05
—
64069636
—
KY
01
—
P00017648
RAILROAD
KY
01
—
P01040544
MEDICARE RAILROAD
KY
Enumeration date
06/01/2005
Last updated
01/23/2019
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