Provider Demographics
NPI:1093081796
Name:HOSACK, LUKE WILLIAM (MD)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:WILLIAM
Last Name:HOSACK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 BRYANT WILLIAMS DR STE 1
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1121
Mailing Address - Country:US
Mailing Address - Phone:541-884-7746
Mailing Address - Fax:
Practice Address - Street 1:2200 BRYANT WILLIAMS DR STE 1
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1121
Practice Address - Country:US
Practice Address - Phone:541-884-7746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-27
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program