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General NPI Number Information
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NPI Number | 1063030302
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Entity Type | Individual
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Provider Name | LUKE JOSEPH ARMSTRONG OD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2020
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Last Update Date | 07/13/2020
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Provider Practice Location Address
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Address Line | 1120 LAKE LAND BLVD
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City | MATTOON
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State | IL
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Zip | 61938-5541
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Country | US
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Telephone | 217-258-8466
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Fax |
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Provider Business Mailing Address
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Address Line | 303 N KELLER DR
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City | EFFINGHAM
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State | IL
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Zip | 62401-1859
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Country | US
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Telephone | 217-342-2672
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Fax | 217-342-2681
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 046011455
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License Number State | IL
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