| Organization Name: | ERNEST A. LUCERO, MD PC |
| NPI Number: | 1912189697 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ERNEST ANTHONY LUCERO (PRESIDENT) |
| Mailing Address: | 6641 Kaniksu St Ste B Bonners Ferry |
| State: | ID US |
| Postal Code: | 838057532 |
| Phone Number: | 2082672086 |
| Fax Number: | 2082674013 |
| NPI Enumeration Date: | 12/04/2007 |
| NPI Last Update Date: | 12/04/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | M5577 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | ID |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |