Healthcare Provider Details

I. General information

NPI: 1609454784
Provider Name (Legal Business Name): LUKE HARRISON HEIL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2021
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 S LIMESTONE STE K201
LEXINGTON KY
40536-0293
US

IV. Provider business mailing address

800 ROSE ST RM MN472
LEXINGTON KY
40536-0293
US

V. Phone/Fax

Practice location:
  • Phone: 859-218-2509
  • Fax: 859-323-3499
Mailing address:
  • Phone: 859-323-5157
  • Fax: 859-323-1214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number59374
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: