Luckett, Robert Tyler

Luckett, Robert Tyler is an individual health care provider with primary practice located at 2630 Grant Line Rd , New Albany IN 47150-4053. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Luckett, Robert Tyler can be contacted via phone (812) 945-0145.

Contact Information

Primary practice address
2630 Grant Line Rd New Albany IN 47150-4053
Phone: (812) 945-0145
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 51653 Kentucky
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 51653 Kentucky

Profile Details

NPI number 1972999050
LBN Legal business name Luckett, Robert Tyler
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 15th, 2015
Last updated Aug 22nd, 2023 - about last year

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 1972999050 NPPES
Kentucky MEDICAID 7100593730

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