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Individual

DR. MICHAEL E LUCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1401 25TH ST S, GREAT FALLS, MT 59405-5183
(406) 731-8888
(406) 731-8888
Mailing address
1401 25TH ST S, GREAT FALLS, MT 59405-5183
(406) 731-8888
(406) 731-8888

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6534
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000096780
BLUE CROSS BLUE SHIELD
MT
05
0027047
MT
01
0148586
WASHINGTON L & I
MT
01
184609700
FEDERAL WORK COMP
MT
01
200039916
RAILROAD MEDICARE
MT
01
810347861
CHAMPUS
MT
01
810347861010
EBMS
MT
Enumeration date
06/26/2006
Last updated
07/21/2022
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