Doctor Name: | DR. JAMES GERARD LUETKEMEYER |
NPI Number: | 1871643494 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 103154 |
Business Practice Address: | 1705 Christy Dr Ste. 101 Jefferson City, MO - 651015195 |
Business Phone Number: | 5736350115 |
Business Fax Number: | 5736350116 |
Mailing Address: | 1705 Christy Dr, Ste. 101 JEFFERSON CITY |
State: | MO |
Postal Code: | 651015195 |
Phone Number: | 5736350115 |
Fax Number: | 5736350116 |
NPI Enumeration Date: | 01/12/2007 |
NPI Last Update Date: | 12/18/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 103154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |