Doctor Name: | DR. DEIRDRE ANN SCHLUCKEBIER |
NPI Number: | 1205114972 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 38067 |
Business Practice Address: | 650 Joel Dr Fort Campbell, KY - 422235318 |
Business Phone Number: | 2707988031 |
Business Fax Number: | |
Mailing Address: | 650 Joel Dr, FORT CAMPBELL |
State: | KY |
Postal Code: | 422235318 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 07/29/2011 |
NPI Last Update Date: | 07/29/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 171000000X |
License Number: | 38067 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KY |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Military Health Care Provider |
Taxonomy Specialization: | |
Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |