Gwynetta Maria Luckett
MD | Pediatrics | Female
Gwynetta Maria Luckett, MD is a Fort Campbell, Kentucky based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of Gwynetta Maria Luckett is
650 Joel Dr, Fort Campbell, Kentucky - 42223-5318. She can be contacted on phone at
270-798-8388.
Gwynetta Maria Luckett is a sole proprietor of her business.
NPI number (Unique professional ID) for Gwynetta Maria Luckett is
1053386185 which was assigned by NPPES on 22 Feb, 2006 and it was last updated on 08 Dec, 2014.
Gwynetta Maria Luckett license number is
35400 for Pediatrics (208000000X) in Tennessee.
Gwynetta Maria Luckett is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
Gwynetta Maria Luckett basic information including her official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | Gwynetta Maria Luckett |
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| Credential : | MD |
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| Gender : | Female |
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Business Address:
Gwynetta Maria Luckett address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 650 Joel Dr
Fort Campbell, KY, 42223-5318
United States |
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| Phone Number : | 270-798-8388 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1053386185 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 22 Feb, 2006 |
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| Last Updated On : | 08 Dec, 2014 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Gwynetta Maria Luckett are as mentioned. Primary taxonomy code for Gwynetta Maria Luckett, MD is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | 35400 | TN |
Legacy Identifiers:
Other legacy medical identifiers of Gwynetta Maria Luckett such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 5441880 | MEDICAID | TN | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 650 Joel Dr
Fort Campbell, KY, 42223-5318
United States |
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| Phone Number : | 270-798-8388 |
|---|
Business Location:
Patients can refer following map for directions to
Gwynetta Maria Luckett practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.