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Individual

ROBERT TYLER LUCKETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2630 GRANT LINE RD, NEW ALBANY, IN 47150-4053
(502) 888-1988
Mailing address
PO BOX 381468, GERMANTOWN, TN 38183-1468

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
01085380A
IN
207RG0100X
Gastroenterology Physician
Primary
51653
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300027790
IN
05
7100593730
KY
Enumeration date
04/15/2015
Last updated
02/16/2026
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