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General NPI Number Information
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NPI Number | 1487611000
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Entity Type | Individual
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Provider Name | EDWARD A LUCE MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 02/01/2019
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Provider Practice Location Address
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Address Line | 1068 CRESTHAVEN RD STE 500
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City | MEMPHIS
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State | TN
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Zip | 38119
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Country | US
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Telephone | 901-866-8525
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Fax |
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Provider Business Mailing Address
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Address Line | 1407 UNION AVE STE 700
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City | MEMPHIS
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State | TN
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Zip | 38104-3641
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Country | US
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Telephone | 901-866-8622
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Fax |
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 38936
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License Number State | TN
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