Individual
MALLORY NOELLE LUCKEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
640 PUDDINGSTONE PKWY, BANNER ELK, NC 28604-7418
(864) 237-4021
(864) 778-8417
Mailing address
640 PUDDINGSTONE PKWY, BANNER ELK, NC 28604-7418
(864) 237-4021
(864) 778-8417
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL39661
SC
2084N0400X
Neurology Physician
2022-01271
NC
2084N0400X
Neurology Physician
2023006973
MO
2084N0400X
Neurology Physician
Primary
302609
NY
2084N0400X
Neurology Physician
MD214178
OR
2084N0400X
Neurology Physician
ME159060
FL
Other
Enumeration date
06/07/2016
Last updated
04/04/2024
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