Provider Demographics
NPI:1225133515
Name:WORKMAN, LUCCUS LEE (DC)
Entity Type:Individual
Prefix:DR
First Name:LUCCUS
Middle Name:LEE
Last Name:WORKMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5183 CLINTON RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STEDMAN
Mailing Address - State:NC
Mailing Address - Zip Code:28391-9516
Mailing Address - Country:US
Mailing Address - Phone:910-482-4444
Mailing Address - Fax:910-482-4441
Practice Address - Street 1:5183 CLINTON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:STEDMAN
Practice Address - State:NC
Practice Address - Zip Code:28391-9516
Practice Address - Country:US
Practice Address - Phone:910-482-4444
Practice Address - Fax:910-482-4441
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3494111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2459343Medicare PIN
NCV12543Medicare UPIN