Individual
LUKE D KILLPACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
10238 E HAMPTON AVE STE 404, MESA, AZ 85209-3319
(480) 771-7546
Mailing address
PO BOX 1792, HIGLEY, AZ 85236-1792
(480) 771-7546
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
5101022765
MI
207N00000X
Dermatology Physician
Primary
7861
AZ
390200000X
Student in an Organized Health Care Education/Training Program
0116028208
VA
Other
Enumeration date
06/22/2015
Last updated
04/10/2025
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