Provider Demographics
NPI:1164429544
Name:LUKE, DUANE JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:DUANE
Middle Name:JOHN
Last Name:LUKE
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 1:200 W 134TH PL
Mailing Address - Street 2:
Mailing Address - City:CUT OFF
Mailing Address - State:LA
Mailing Address - Zip Code:70345-4143
Mailing Address - Country:US
Mailing Address - Phone:985-798-7000
Mailing Address - Fax:985-798-7021
Practice Address - Street 1:176 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:GOLDEN MEADOW
Practice Address - State:LA
Practice Address - Zip Code:70357-2938
Practice Address - Country:US
Practice Address - Phone:985-475-5200
Practice Address - Fax:985-475-5664
Is Sole Proprietor?:No
Enumeration Date:2005-06-30
Last Update Date:2007-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA024310207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1571652Medicaid
LA1571652Medicaid
LA4A249Medicare ID - Type Unspecified