Individual
MICHAEL RUDOLPH LUCERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1050 NOD ST, KNOXVILLE, TN 37932-3717
(505) 328-2236
Mailing address
1050 NOD ST, KNOXVILLE, TN 37932-3717
(505) 328-2236
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5375
TN
Other
Enumeration date
01/27/2023
Last updated
01/27/2023
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