Individual
HEATHER MARIE TLUCZEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
4005 DUPONT CIR, LOUISVILLE, KY 40207-4801
(502) 897-7401
Mailing address
425 LEWIS HARGETT CIR, LEXINGTON, KY 40503-3590
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
03074
KY
207L00000X
Anesthesiology Physician
2003261A
IN
208VP0000X
Pain Medicine Physician
02003261A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000577530
ANTHEM
—
05
—
200918380
—
IN
Enumeration date
02/13/2007
Last updated
08/16/2019
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