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Individual

DR. PAUL A LUCKY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10506 MONTGOMERY RD STE 402, CINCINNATI, OH 45242-4489
(513) 791-6161
(513) 791-4085
Mailing address
5300 FAR HILLS AVE, DAYTON, OH 45429-2381
(937) 433-7536
(937) 433-9612

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
35049616
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0538912
OH
Enumeration date
03/08/2007
Last updated
06/08/2017
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