Provider Demographics
NPI:1437245602
Name:ARTEAGA, LUCIO JR (MD)
Entity Type:Individual
Prefix:
First Name:LUCIO
Middle Name:
Last Name:ARTEAGA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUKE
Other - Middle Name:
Other - Last Name:ARTEAGA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:7331 E OSBORN DR
Mailing Address - Street 2:170
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6435
Mailing Address - Country:US
Mailing Address - Phone:480-945-0789
Mailing Address - Fax:480-945-0206
Practice Address - Street 1:7331 E OSBORN DR
Practice Address - Street 2:170
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:480-945-0789
Practice Address - Fax:480-945-0206
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ16150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZC99075Medicare UPIN