Individual
JOHN SETH LUKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 CEDAR ST, OROFINO, ID 83544-9029
(208) 476-4555
(208) 476-5385
Mailing address
11234 ANDERSON ST, LLUMC, HOUSE STAFF OFFICE CP 21005, LOMA LINDA, CA 92354-2804
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M13875
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801089834
—
ID
Enumeration date
08/23/2007
Last updated
12/19/2017
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