Provider Demographics
NPI:1134777584
Name:HASKINS, LUKE MICHAEL (PA-C)
Entity type:Individual
Prefix:
First Name:LUKE
Middle Name:MICHAEL
Last Name:HASKINS
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 MIDWAY DR STE B
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-3857
Mailing Address - Country:US
Mailing Address - Phone:814-371-2348
Mailing Address - Fax:814-372-6089
Practice Address - Street 1:135 MIDWAY DR STE B
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-3857
Practice Address - Country:US
Practice Address - Phone:814-371-2348
Practice Address - Fax:814-372-6089
Is Sole Proprietor?:No
Enumeration Date:2019-08-29
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060822363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant