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General NPI Number Information
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NPI Number | 1689757379
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Entity Type | Organization
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Legal Business Name | ARMOUR ROAD FAMILY MEDICINE, PC
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Dates
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Enumeration Date | 10/24/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4820 ARMOUR ROAD SUITE A-7
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City | COLUMBUS
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State | GA
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Zip | 31904
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Country | US
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Telephone | 706-320-9959
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Fax | 706-320-9950
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Provider Business Mailing Address
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Address Line | 4820 ARMOUR ROAD SUITE A-7
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City | COLUMBUS
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State | GA
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Zip | 31904
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Country | US
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Telephone | 706-320-9959
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Fax | 706-320-9950
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Authorized Official
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Title or Position | CEO/PHYSICIAN
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Name | STEVEN J. LUCKS
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Credential | M.D.
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Telephone | 706-320-9959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 047481
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License Number State | GA
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