Provider Demographics
NPI:1407805641
Name:LUKENS, DAVID GENE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:GENE
Last Name:LUKENS
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 1:1201 N POST RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4246
Mailing Address - Country:US
Mailing Address - Phone:317-355-5250
Mailing Address - Fax:317-355-9663
Practice Address - Street 1:1201 N POST RD
Practice Address - Street 2:SUITE 4
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46219-4246
Practice Address - Country:US
Practice Address - Phone:317-355-5250
Practice Address - Fax:317-355-9663
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031925207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000312424OtherANTHEM
INP00128646OtherRRMEDICARE
IN214210CMedicare PIN
INB29565Medicare UPIN