Individual
MR. MARC LUCKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
Mailing address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(913) 651-1041
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036154158
IL
207V00000X
Obstetrics & Gynecology Physician
04-34430
KS
207V00000X
Obstetrics & Gynecology Physician
Primary
2002014395
MO
Other
Enumeration date
02/10/2006
Last updated
05/01/2026
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