Provider Demographics
NPI:1265728356
Name:LUKAS, LANA JEAN (OD)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:JEAN
Last Name:LUKAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:326 COPPERCREEK CIR
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-6808
Mailing Address - Country:US
Mailing Address - Phone:812-327-5095
Mailing Address - Fax:
Practice Address - Street 1:757 E LEWIS AND CLARK PKWY
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47129-2269
Practice Address - Country:US
Practice Address - Phone:812-288-8566
Practice Address - Fax:812-284-2326
Is Sole Proprietor?:No
Enumeration Date:2011-06-27
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003674A152W00000X
KY1858DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist