Luckasen, Gary J
Luckasen, Gary J is an individual health care provider with primary practice located at 2121 E Harmony Rd Unit 100, Fort Collins CO 80528-3401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Luckasen, Gary J can be contacted via phone (970) 221-1000.Contact Information
Primary practice address
2121 E Harmony Rd Unit 100
Fort Collins CO 80528-3401
Phone: (970) 221-1000
Fax: (970) 297-6860
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 20789 | Colorado |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 19652 | Nebraska |
Profile Details
| NPI number | 1063418572 |
|---|---|
| LBN Legal business name | Luckasen, Gary J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Jun 12th, 2014 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063418572 | NPPES |
| Nebraska | Other | P00970356 | MEDICARE RAILROAD |
| Nebraska | MEDICAID | 103400600 | MEDICARE RAILROAD |
| Nebraska | MEDICAID | 01207893 | MEDICARE RAILROAD |
| Nebraska | Other | P00910572 | MEDICARE RAILROAD |
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