| Thomas Jordan Lucak, MD | |
|
6300 E Lake Blvd Ste 201, Vancleave, MS 39565-6771 | |
| (228) 230-2663 | |
| (228) 546-3257 |
| Full Name | Thomas Jordan Lucak |
|---|---|
| Gender | Male |
| Speciality | Orthopaedic Surgery |
| Location | 6300 E Lake Blvd Ste 201, Vancleave, Mississippi |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598185563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | 27538 (Mississippi) | Primary |
| Entity Name | Oal Care Of Al, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720540693 PECOS PAC ID: 1254668031 Enrollment ID: O20210422000100 |
| Mailing Address | Practice Location Address |
|---|---|
| Thomas Jordan Lucak, MD 6300 E Lake Blvd Ste 301, Vancleave, MS 39565-6771 Ph: (228) 230-2663 | Thomas Jordan Lucak, MD 6300 E Lake Blvd Ste 201, Vancleave, MS 39565-6771 Ph: (228) 230-2663 |
Matthew Wesley Lewis, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565 Phone: 228-206-2263 Fax: 228-206-1192 | |
Charles Joseph Winters, M.D. Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 6300 E Lake Blvd Ste 201, Vancleave, MS 39565 Phone: 228-230-2663 Fax: 228-546-3257 | |
Dr. Daniel Allen Wittersheim, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565 Phone: 228-230-2663 Fax: 228-206-1192 | |
Dr. John Kirk Drake, M.D. Orthopedic Surgery Medicare: Not Enrolled in Medicare Practice Location: 6300 E Lake Blvd, Suite 201, Vancleave, MS 39565 Phone: 228-230-2663 Fax: 228-206-1192 | |
David P Taormina, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 6300 E Lake Blvd Ste 201, Vancleave, MS 39565 Phone: 228-230-2663 Fax: 228-546-3257 | |
Dr. Christopher Burks, MD Orthopedic Surgery Medicare: Accepting Medicare Assignments Practice Location: 6300 E Lake Blvd, Suite 301, Vancleave, MS 39565 Phone: 228-230-2663 Fax: 228-206-1192 |