Individual
PATRICIA D. LUCKEROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
665 WINTER ST SE, SALEM, OR 97301-3934
(503) 561-2448
Mailing address
PO BOX 13129, SALEM, OR 97309-1129
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
225417
MA
208600000X
Surgery Physician
Primary
MD175434
OR
2086S0105X
Surgery of the Hand (Surgery) Physician
A116738
CA
Other
Enumeration date
01/22/2007
Last updated
01/11/2019
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