Provider Demographics
NPI:1730287004
Name:LUKER, STEPHEN N (DO)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:N
Last Name:LUKER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 WEST D.L. INGRAM AVE
Mailing Address - Street 2:BLDG 1408
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88101
Mailing Address - Country:US
Mailing Address - Phone:575-784-7625
Mailing Address - Fax:
Practice Address - Street 1:224 WEST D.L. INGRAM AVE
Practice Address - Street 2:BLDG 1408
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101
Practice Address - Country:US
Practice Address - Phone:575-784-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2018-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-8915207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSI23139Medicare UPIN
MS080004030Medicare ID - Type Unspecified