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:
Health care specialties
| Specialty | Code | License # | 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 19 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 | 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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