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NPI Code Detail

MEDICARE: TAYLOR ALLISON LUKAS PA-C

MEDICARE: TAYLOR ALLISON LUKAS PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician Assistant6209AZ
2363A00000XPhysician Assistant6209AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1396114922
Entity Type Code : Individual
Provider Name (Legal Business Name) : TAYLOR ALLISON LUKAS PA-C
Provider Business Mailing Address
First Line : 7500 N DREAMY DRAW DR STE 145
Second Line :
City : PHOENIX
State : AZ
Zip : 85020-4668
Country : US
Telephone Number : 480-882-4545
Fax Number : 480-882-5814
Provider Business Practice Location Address
First Line : 20440 N 27TH AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85027-3240
Country : US
Telephone Number : 480-882-4545
Fax Number : 480-882-5017
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2015
Last Update Date : 12/23/2022

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