Provider Demographics
NPI:1255373015
Name:LUCK, ALLAN J (MD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:J
Last Name:LUCK
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3267 S 16TH ST
Mailing Address - Street 2:OHIO BUILDING - ROOM 209
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53215-4500
Mailing Address - Country:US
Mailing Address - Phone:414-389-3111
Mailing Address - Fax:414-389-3110
Practice Address - Street 1:3267 S 16TH ST
Practice Address - Street 2:OHIO BUILDING - ROOM 209
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4500
Practice Address - Country:US
Practice Address - Phone:414-389-3111
Practice Address - Fax:414-389-3110
Is Sole Proprietor?:No
Enumeration Date:2006-06-13
Last Update Date:2008-04-18
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Provider Licenses
StateLicense IDTaxonomies
WI149692084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30951800Medicaid
WI30951800Medicaid