Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 2017-00196 | NC |
Y | 207X00000X | Orthopaedic Surgeon | MD464520 | PA |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 2017-00196 | NC |
NPI | 1023384997 |
---|---|
Provider Name | Dr. Lucas E Nikkel |
First Address | Hershey, PA 17033-0858 |
Second Address | Hershey, PA 17033-2036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2012 |
Last Update Date | 19/09/2018 |