Organization
LUCAS,PARKS,REA & VANDAALEN, PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRANCO R REA M.D. (OWNER)
(502) 366-8825
Entity
Organization
Contact information
Practice address
4402 CHURCHMAN AVE, STE, 205, LOUISVILLE, KY 40215-1190
(502) 366-8825
(502) 366-0044
Mailing address
4402 CHURCHMAN AVE, STE, 205, LOUISVILLE, KY 40215-1190
(502) 366-8825
(502) 366-0044
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
17917
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
19706
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
26040
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
27240
KY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
28268
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
32579
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
40712
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
46343
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1048803
PASSPORT
KY
05
—
65926958
—
KY
01
—
CN3171
RAILROAD MEDICARE
—
Enumeration date
01/25/2007
Last updated
10/11/2007
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