Individual
DR. LUKE KICKLIGHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 DELAWARE ST SE # 480, MINNEAPOLIS, MN 55455-0341
(612) 626-0400
Mailing address
PO BOX 980257, RICHMOND, VA 23298-0257
(804) 828-9783
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0116035128
VA
207RH0003X
Hematology & Oncology Physician
Primary
80093
MN
208000000X
Pediatrics Physician
0116035128
VA
Other
Enumeration date
04/22/2021
Last updated
06/20/2025
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