Doctor Name: | MIA M LUKE |
NPI Number: | 1497182455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | R MR |
License Number: | 409616 |
Business Practice Address: | 1401 Tift Ave N Ste E Tifton, GA - 317943585 |
Business Phone Number: | 2293876799 |
Business Fax Number: | 2293876791 |
Mailing Address: | 1401 Tift Ave N, Ste E TIFTON |
State: | GA |
Postal Code: | 317943585 |
Phone Number: | 2293876799 |
Fax Number: | 2293876791 |
NPI Enumeration Date: | 10/04/2013 |
NPI Last Update Date: | 10/09/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247100000X |
License Number: | 409616 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Radiologic Technologist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is trained and qualified in the art and science of both ionizing and non-ionizing radiation for the purposes of diagnostic medical imaging, interventional procedures and therapeutic treatment. |