Individual
RICHARD E LUCKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
126 HOSPITAL AVE, OZARK, AL 36360-2018
(334) 793-8087
(334) 793-8191
Mailing address
PO BOX 863, OZARK, AL 36361-0863
(334) 793-8087
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1-084888
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952573545
—
AL
01
—
51044800
BCBS OF AL
AL
Enumeration date
03/24/2008
Last updated
01/21/2009
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