Dr. Jeanvickey Lusk, M.d. & Co. P.c.

NPI 1184020174 - Family Medicine - 207Q00000X

NPI Details
NPI 1184020174
Enumeration Date 11/18/2014
Last Updated 11/18/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name JEANVICKEY JEANVICKEY
Position OWNER
Phone (215) 200-8447
Fax
Practice Location
315 GYPSY LANE
KING OF PRUSSIA PA, 19406, US
Phone (215) 200-8447
Fax
Business Location
P.O. BOX 60940
KING OF PRUSSIA PA, 19406, US
Phone
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Alabama
License Number 5800
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According to our database, Dr. Jeanvickey Lusk, M.d. & Co. P.c. NPI is 1184020174, taxonomy code is 207Q00000X and license number is 5800, license state is located at Alabama. Dr. Jeanvickey Lusk, M.d. & Co. P.c. physically located at 315 Gypsy Lane, King Of Prussia PA, 19406. NPI Number 1033115704 has the healthcare provider type.

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1184020174 NPI number is provided on an as is basis without warranty of any kind. 1184020174 is maintained by the National Plan & Provider Enumeration System. The contents of Dr. Jeanvickey Lusk, M.d. & Co. P.c. are for informational purposes only.