Luckasen, John R

Luckasen, John R is an individual health care provider with primary practice located at 4242 Farnam St Ste 360, Omaha NE 68131-2850. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Luckasen, John R can be contacted via phone (402) 552-2555.

Contact Information

Primary practice address
4242 Farnam St Ste 360 Omaha NE 68131-2850
Phone: (402) 552-2555
Fax: (402) 552-2573
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 12194 Nebraska

Profile Details

NPI number 1114921525
LBN Legal business name Luckasen, John R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jul 9th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114921525 NPPES
Nebraska Other 139381XX PREFERRED CARE
Nebraska Other 91864 PREFERRED CARE
Nebraska MEDICAID 47062325613 PREFERRED CARE
Nebraska Other 501880 PREFERRED CARE
Nebraska Other 0001967 PREFERRED CARE
Nebraska Other 00686 PREFERRED CARE
Nebraska MEDICAID 0918649 PREFERRED CARE
Nebraska Other 0300003 PREFERRED CARE
Nebraska MEDICAID 7787680 PREFERRED CARE

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