Individual
DIANA MARIA VALLECILLA LUKAUSKIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
330 TURNER MCCALL BLVD SW, ROME, GA 30165-5630
(706) 291-1754
(706) 291-2227
Mailing address
221 TECHNOLOGY PKWY NW, ROME, GA 30165-1369
(762) 235-1000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
058590
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
873915717B
—
GA
Enumeration date
02/13/2007
Last updated
05/05/2020
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