MEDICARE: MR. SAMUEL SIMON LAUCKS II MD

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
1	208600000X	Surgery Physician	MD027130E	PA
2	208C00000X	Colon & Rectal Surgery Physician	MD027130E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	127981	OTHER	PA	BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	01303901	OTHER	PA	BLUE CROSS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487662342
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SAMUEL SIMON LAUCKS II MD

Provider Business Mailing Address
First Line	:	601 MEMORY LN
Second Line	:
City	:	YORK
State	:	PA
Zip	:	17402-2231
Country	:	US
Telephone Number	:	717-851-1405
Fax Number	:

Provider Business Practice Location Address
First Line	:	840 TUCK ST
Second Line	:
City	:	LEBANON
State	:	PA
Zip	:	17042-7477
Country	:	US
Telephone Number	:	717-675-2545
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	05/19/2026

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