Individual
BETHANY L LUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3251 N WINDSONG DR, PRESCOTT VALLEY, AZ 86314-1222
(928) 772-2582
(928) 772-2383
Mailing address
PO BOX 26568, PRESCOTT VALLEY, AZ 86312-6568
(928) 778-1251
(928) 778-7834
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32468
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20-0641187
UNITED HEALTH
AZ
01
—
869638
ACCHS
AZ
01
—
AZ0749400
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
08/30/2006
Last updated
10/16/2018
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