Provider Demographics
NPI:1104323468
Name:DELAIN, LUKE JOSEPH (DO)
Entity type:Individual
Prefix:DR
First Name:LUKE
Middle Name:JOSEPH
Last Name:DELAIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4132 CANDLEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76308-4442
Mailing Address - Country:US
Mailing Address - Phone:940-676-1221
Mailing Address - Fax:
Practice Address - Street 1:527 TUSKEGEE AIRMEN AVE
Practice Address - Street 2:BLDG 500
Practice Address - City:SHEPPARD AFB
Practice Address - State:TX
Practice Address - Zip Code:76311
Practice Address - Country:US
Practice Address - Phone:940-676-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02005757A171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider