Provider Demographics
NPI:1386613289
Name:LUK, BELINDA MW (OD)
Entity type:Individual
Prefix:DR
First Name:BELINDA
Middle Name:MW
Last Name:LUK
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:211 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-6220
Mailing Address - Country:US
Mailing Address - Phone:573-446-0331
Mailing Address - Fax:800-432-6004
Practice Address - Street 1:1400 FORUM BLVD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-1997
Practice Address - Country:US
Practice Address - Phone:573-446-0331
Practice Address - Fax:800-432-6004
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2008-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000167741152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
122146OtherCOLE
222110OtherGROUP HEALTH PLAN
675347OtherHEALTHLINK
MO7741OtherEYEMED
UNKNOWNOtherUNITED HEALTHCARE
MO317641512Medicaid
UNKNOWNOtherDAVIS VISION
UNKNOWNOtherOPTICARE MED.COMPLET
MO317641504Medicaid
MO23891OtherHEALTHCARE USA
UNKNOWNOtherVISION CARE PLAN
178778OtherBLUE CROSS BLUE SHIELD
MO990101722Medicare PIN
MOU82483Medicare UPIN
MO317641504Medicaid
122146OtherCOLE