LUKE D KILLPACK (NPI# 1679955041) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679955041 |
| Entity Type | Individual |
| Full Name | LUKE D KILLPACK |
| Credential | D.O. |
| Practice Address |
5333 Mcauley Dr Rm 5003 Ypsilanti MI 48197-1020 |
| Practice Telephone | 7347123376 |
| Mailing Telephone | 4805704613 |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2018-11-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 5101022765 | MI | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | 0116028208 | VA | Student, Health Care |
| Street Address |
5333 MCAULEY DR RM 5003 |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197-1020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811345093 | Molly Buckland | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2016-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700423092 | Devika Dibya Choudhuri | Counselor | 135 Porter West Circle Drive, Ypsilanti, MI 48197 | 2019-12-05 |
| 1770128837 | Brian Lee Shue | Registered Nurse | 6277 Maplehurst Dr, Ypsilanti, MI 48197 | 2019-11-13 |
| 1639721566 | Darlene E Bellers | 845 W. Circle Dr, Suite 160, Ypsilanti, MI 48197 | 2019-07-11 | |
| 1073165874 | Eastern Michigan University | Dietitian, Registered | Suite 160 Rackham, Ypsilanti, MI 48197 | 2019-07-11 |
| 1447815469 | Rainbow Rehabilitation Centers, Inc. | Community Based Residential Treatment Facility, Mental Illness | 6200 Textile Rd, Ypsilanti, MI 48197 | 2019-05-06 |
| 1417416298 | Justin Brewer | Student in an Organized Health Care Education/Training Program | 5333 Mcauley Drive Suite 2115, Ypsilanti, MI 48197 | 2019-03-19 |
| 1124519780 | Great Lakes Mindfulness LLC | Community/Behavioral Health | 4007 Carpenter Rd # 280, Ypsilanti, MI 48197 | 2018-05-19 |
| 1841799715 | Bedside Angel's Home Care, LLC | Home Health | 2032 S. Congress Street, Ypsilanti, MI 48197 | 2018-02-06 |
| 1891211777 | Brandon James Kukal | Specialist/Technologist | 799 N Hewitt, Ypslinati, MI 48197 | 2017-08-22 |
| 1669908737 | Michael Bekkerman | Student in an Organized Health Care Education/Training Program | 5303 Elliot Drive, Cancer Center, Ypsilanti, MI 48197 | 2017-05-10 |
| Find all providers in zip 48197 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770080939 | Emily Rose Davis | Dermatology | 5333 Mcauley Dr Rm 2111, Ypsilanti, MI 48197-1097 | 2018-04-12 |
| 1811345093 | Molly Buckland | Dermatology | 5333 Mcauley Dr Rm 5003, Ypsilanti, MI 48197-1020 | 2016-05-29 |
| 1740638949 | Ashley Reader | Dermatology | 5333 Mcauley Drive, Suite 5003, Ypsilanti, MI 48197-1014 | 2016-05-27 |
| 1235517418 | Iha Health Services Corporation | Dermatology | 5333 Mcauley Dr, 5th Floor, Suite 5003, Ypsilanti, MI 48197-1014 | 2015-05-08 |
| 1679968150 | Michael Dewall | Dermatology | 5301 E Huron River Dr, Ypsilanti, MI 48197-1051 | 2015-04-01 |
| 1871901918 | Kaylan Pustover | Dermatology | 5333 Mcauley Dr, Suite 5003, Ypsilanti, MI 48197-1014 | 2014-07-31 |
| 1861818676 | Jennifer Vermeesch | Dermatology | 5333 Mcauley Dr, Suite 5003, Ypsilanti, MI 48197-1014 | 2014-03-17 |
| 1164858221 | Iha Health Services Corporation | Dermatology | 4990 W Clark Rd, Ste 400, Ypsilanti, MI 48197-1149 | 2013-09-20 |
| 1285898155 | Hyuk C Cha | Dermatology | 4990 W Clark Rd, Ste 400, Ypsilanti, MI 48197-1149 | 2008-07-10 |
| 1609995125 | St Joseph Mercy Hospital | Dermatology | 5301 E Huron River Dr, Pathology Department, Ypsilanti, MI 48197-1051 | 2007-03-28 |
| Find all providers in YPSILANTI | ||||
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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.