Provider Demographics
NPI:1669623880
Name:JOSEPH A LUKASKA, MD FAMILY MEDICINE, PLLC
Entity type:Organization
Organization Name:JOSEPH A LUKASKA, MD FAMILY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:A
Authorized Official - Last Name:LUKASKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:931-588-1778
Mailing Address - Street 1:190 PROSSER RD
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:TN
Mailing Address - Zip Code:38464-4233
Mailing Address - Country:US
Mailing Address - Phone:931-762-1559
Mailing Address - Fax:931-762-1563
Practice Address - Street 1:190 PROSSER RD
Practice Address - Street 2:
Practice Address - City:LAWRENCEBURG
Practice Address - State:TN
Practice Address - Zip Code:38464-4233
Practice Address - Country:US
Practice Address - Phone:931-762-1559
Practice Address - Fax:931-762-1563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-07
Last Update Date:2011-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN44178207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty