Individual
DR. JEREMY D. LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2851 NEW HARTFORD RD STE A, OWENSBORO, KY 42303
(270) 240-2305
Mailing address
2851 NEW HARTFORD RD STE A, OWENSBORO, KY 42303-1320
(270) 240-2305
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
44246
KY
208M00000X
Hospitalist Physician
01073931A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100171880
—
KY
Enumeration date
07/21/2008
Last updated
01/17/2019
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