Luckett, Jeffrey

Luckett, Jeffrey is an sole proprietor health care provider with primary practice located at 9200 N Central Ave Ste 2 , Phoenix AZ 85020-2463. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Luckett, Jeffrey can be contacted via phone (480) 999-4954.

Contact Information

Primary practice address
9200 N Central Ave Ste 2 Phoenix AZ 85020-2463
Fax: (480) 999-4712
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X AP8054 Arizona

Profile Details

NPI number 1336519552
LBN Legal business name Luckett, Jeffrey
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 30th, 2015
Last updated May 5th, 2023 - about 3 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 1336519552 NPPES
Arizona MEDICAID 096036

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