Provider Demographics
NPI:1033173760
Name:LUK, KENNETH H (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:H
Last Name:LUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1760 E RIVER RD
Mailing Address - Street 2:STE. # 350
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5877
Mailing Address - Country:US
Mailing Address - Phone:520-519-7775
Mailing Address - Fax:520-519-7910
Practice Address - Street 1:1916 W BETHANY HOME RD
Practice Address - Street 2:SUITE 100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015-2458
Practice Address - Country:US
Practice Address - Phone:602-283-7979
Practice Address - Fax:602-864-5031
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ207772085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ268921OtherAHCCCS
AZA24097Medicare UPIN
AZZ126900Medicare PIN
AZZ105955Medicare PIN
AZ141083Medicare PIN