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
Phone: (480) 999-4954
Fax: (480) 999-4712
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336519552 | NPPES |
| Arizona | MEDICAID | 096036 |
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