MR. GILBERT LYNN LUCKEL JR. (NPI# 1275934580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275934580 |
| Entity Type | Individual |
| Full Name | MR. GILBERT LYNN LUCKEL JR. |
| Credential | AG-ACNP |
| Practice Address |
101 Courtenay Cir Hattiesburg MS 39402-3176 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6015795180 |
| Practice Fax Number | 6015795374 |
| Mailing Telephone | 6015795180 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2014-09-06 |
| Last Update Date | 2020-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | R884250 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
R884250 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 01001724 | 05 |
| Street Address |
101 COURTENAY CIR |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-3176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831251925 | Hattiesburg Clinic Pa | Clinic/Center | 101 Courtenay Cir, Hattiesburg, MS 39402-3153 | 2006-12-14 |
| 1164559639 | John Richard Harsh | Psychologist | 101 Courtenay Cir, Hattiesburg, MS 39402-3153 | 2007-02-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447893888 | Spectrum The Other Clinic | Nurse Practitioner | 2910 Magnolia Pl, Hattiesburg, MS 39402-2428 | 2019-10-17 |
| 1073630307 | Brandi Renee Garris | Nurse Practitioner | 20 Rawls Springs Loop Rd, Hattiesburg, MS 39402-7801 | 2007-03-23 |
| 1881702231 | Patricia Dawn Patterson | Nurse Practitioner | 4 Willow Pt, Suite 50, Hattiesburg, MS 39402-1150 | 2006-08-27 |
| 1750888129 | Karen Creel Ladnier | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401 | 2018-04-11 |
| 1346629326 | William Bradley Pickering | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2015-05-24 |
| 1669722336 | Karen Emily Gatlin | Nurse Practitioner | 301 W Pine St, Hattiesburg, MS 39401-3829 | 2012-09-10 |
| 1780930677 | David Mallory Plair | Nurse Practitioner | 3700 Hardy St Ste 10, Hattiesburg, MS 39402-1553 | 2012-07-28 |
| 1801164363 | Robert W Lee II | Nurse Practitioner | 6051 U S Highway 49, Hattiesburg, MS 39401-7200 | 2011-12-12 |
| 1427337765 | Brian Clayton Gibson | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2011-08-04 |
| 1275824088 | Kimberly Rogers Shows | Nurse Practitioner | 415 S 28th Ave, Hattiesburg, MS 39401-7246 | 2011-04-27 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.