Provider Demographics
NPI:1932897758
Name:SON, LUKE LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:LEIGH
Last Name:SON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUKE
Other - Middle Name:L
Other - Last Name:SON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 280
Mailing Address - Street 2:
Mailing Address - City:SPRING CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84662-0280
Mailing Address - Country:US
Mailing Address - Phone:435-557-0444
Mailing Address - Fax:
Practice Address - Street 1:186 S 300 E
Practice Address - Street 2:
Practice Address - City:SPRING CITY
Practice Address - State:UT
Practice Address - Zip Code:84662-7734
Practice Address - Country:US
Practice Address - Phone:435-557-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program