Basic Information
| Provider Information | |||||||||
| NPI: | 1942231691 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUCCHESI | ||||||||
| FirstName: | KENT | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MD | ||||||||
| OtherOrganizationName: | |||||||||
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| OtherLastName: | LUCCHESI | ||||||||
| OtherFirstName: | K. GREGORY | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | MD | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 7 PARKWAY CTR | ||||||||
| Address2: | SUITE 375 | ||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15220 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4129375700 | ||||||||
| FaxNumber: | 4129375739 | ||||||||
| Practice Location | |||||||||
| Address1: | 600 EAST BLVD | ||||||||
| Address2: | |||||||||
| City: | ELKHART | ||||||||
| State: | IN | ||||||||
| PostalCode: | 46514 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5745233193 | ||||||||
| FaxNumber: | 5745233464 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/05/2006 | ||||||||
| LastUpdateDate: | 05/14/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 01040256 | IN | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
No ID Information.