Tracy Renee Luckhardt
Internist Pulmonary Disease Critical Care Medicine
619 19th St S
Birmingham
, Alabama 35249-1900
Tracy Renee Luckhardt
Internist Pulmonary Disease Critical Care Medicine
619 19th St S
Birmingham
, Alabama 35249-1900
(205) 731-9701
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About
Features
Specialties
- Internist
- Critical Care Medicine
- Pulmonary Disease
Languages spoken
- English
Location
First Address
- Tracy Renee Luckhardt
- Po Box 55310
- Birmingham, AL
- Zip : 35255-5310
- Phone : (205) 731-9701
Second Address
- Tracy Renee Luckhardt
- 619 19th St S
- Birmingham, AL
- Zip : 35249-1900
- Phone : (205) 934-4011
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Is Tracy Renee Luckhardt a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207R00000X | Internist | 29678 | AL |
| Y | 111NI0900X | Internist | 29678 | AL |
| N | 207R00000X | Internist | 4301083942 | MI |
| N | 111NI0900X | Internist | 4301083942 | MI |
| N | 207RC0200X | Critical Care Medicine | 4301083942 | MI |
| N | 207RP1001X | Pulmonary Disease | 4301083942 | MI |
National Provider Identifier
| NPI | 1053431338 |
|---|---|
| Provider Name | Tracy Renee Luckhardt |
| First Address | Birmingham, AL 35255-5310 |
| Second Address | Birmingham, AL 35249-1900 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/03/2007 |
| Last Update Date | 06/07/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 02175009 | (05) | MS |
| 051100466 | BCBS (01) | AL |
| 051100467 | BCBS (01) | AL |
| 051100468 | BCBS (01) | AL |
| 114500 | (05) | AL |
| 114502 | (05) | AL |
| 114504 | (05) | AL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.