Doctor Name: | DR. DEDRICK SPENCER LUIKENS |
NPI Number: | 1851374144 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 3998 |
Business Practice Address: | 480 Central Ave Naval Health Clinic Hawaii, Bhc Kaneohe Bay Pearl Harbor, HI - 968604908 |
Business Phone Number: | 8082575041 |
Business Fax Number: | |
Mailing Address: | 47-510 Hui Iwa St, KANEOHE |
State: | HI |
Postal Code: | 967444615 |
Phone Number: | 8502217832 |
Fax Number: | |
NPI Enumeration Date: | 11/21/2005 |
NPI Last Update Date: | 05/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 3998 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |