Provider Demographics
NPI:1114182904
Name:LOUK, ERNEST (DPM)
Entity Type:Individual
Prefix:DR
First Name:ERNEST
Middle Name:
Last Name:LOUK
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 28654
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89126-2654
Mailing Address - Country:US
Mailing Address - Phone:702-435-4090
Mailing Address - Fax:866-850-0098
Practice Address - Street 1:7601 ROCKFIELD DR
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89128-7929
Practice Address - Country:US
Practice Address - Phone:702-435-4090
Practice Address - Fax:866-850-0098
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-22
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9708213E00000X
MO610213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV101740Medicare PIN
P00370708Medicare PIN