Provider Demographics
NPI:1316995301
Name:LUCKE, JOHN CHARLES (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHARLES
Last Name:LUCKE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:380 WOODS COVE RD
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-2428
Mailing Address - Country:US
Mailing Address - Phone:256-259-4444
Mailing Address - Fax:256-218-3536
Practice Address - Street 1:380 WOODS COVE RD
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2428
Practice Address - Country:US
Practice Address - Phone:256-259-4444
Practice Address - Fax:256-218-3536
Is Sole Proprietor?:No
Enumeration Date:2006-05-04
Last Update Date:2019-08-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC35965208G00000X
AL38432208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)