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General NPI Number Information
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NPI Number | 1124609904
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Entity Type | Individual
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Provider Name | LUCAS W GUNNELS MD
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Gender | Male
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Dates
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Enumeration Date | 04/14/2021
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | BHMG INTERNAL MEDICINE & PEDS. - CRESTWOOD 7101 W. HIGHWAY 22
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City | CRESTWOOD
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State | KY
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Zip | 40014
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Country | US
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Telephone | 502-241-6567
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Fax | 502-241-5083
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Provider Business Mailing Address
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Address Line | 1901 CAMPUS PL
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City | LOUISVILLE
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State | KY
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Zip | 40299-2308
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Country | US
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Telephone | 502-253-4924
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Fax | 502-489-5705
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 60855
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 60855
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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