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NPI Code Detail

MEDICARE: DR. ERICH LUSSNIG MD

MEDICARE: DR. ERICH LUSSNIG 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
12085R0202XDiagnostic Radiology Physician036116778IL
22085R0202XDiagnostic Radiology Physician36899TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750366050
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ERICH LUSSNIG MD
Provider Business Mailing Address
First Line : PO BOX 3233
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46206-3233
Country : US
Telephone Number : 844-584-2194
Fax Number :
Provider Business Practice Location Address
First Line : 1700 MEDICAL CENTER PKWY
Second Line :
City : MURFREESBORO
State : TN
Zip : 37129-2245
Country : US
Telephone Number : 615-396-4100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/08/2005
Last Update Date : 09/13/2017

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