Dr Gary J Luckasen, MD | |
2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 | |
(970) 221-1000 | |
(970) 297-6860 |
Full Name | Dr Gary J Luckasen |
---|---|
Gender | Male |
Speciality | Internal Medicine - Cardiovascular Disease |
Location | 2121 E Harmony Rd, Fort Collins, Colorado |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063418572 | NPI | - | NPPES |
P00970356 | Other | NE | MEDICARE RAILROAD |
103400600 | Medicaid | WY | |
01207893 | Medicaid | CO | |
P00910572 | Other | CO | MEDICARE RAILROAD |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RC0000X | Internal Medicine - Cardiovascular Disease | 20789 (Colorado) | Primary |
207RC0000X | Internal Medicine - Cardiovascular Disease | 19652 (Nebraska) | Secondary |
Entity Name | Poudre Valley Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366763260 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
Mailing Address | Practice Location Address |
---|---|
Dr Gary J Luckasen, MD 2121 E Harmony Rd, Suite 100, Fort Collins, CO 80528-3400 Ph: (970) 221-1000 | Dr Gary J Luckasen, MD 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528-3401 Ph: (970) 221-1000 |
Dr. Stephen A Treat, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2121 E Harmony Rd, Ste 100, Fort Collins, CO 80528 Phone: 970-221-1000 Fax: 970-297-6844 | |
Dr. David Kindley Cobb, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 2121 E Harmony Rd Unit 380, Fort Collins, CO 80528 Phone: 970-224-0429 | |
Dr. Diana M Breyer, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2121 E Harmony Rd, Suite 300, Fort Collins, CO 80528 Phone: 970-224-9102 Fax: 970-224-9112 | |
Fred H Meyer, M.D. Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 219 S Sunset St, Fort Collins, CO 80521 Phone: 970-224-2156 Fax: 970-482-6936 | |
Robert A Simmons, MD Cardiovascular Disease Medicare: Not Enrolled in Medicare Practice Location: 3702 S Timberline Rd, Fort Collins, CO 80525 Phone: 970-207-9773 Fax: 970-207-1893 | |
Dr. Charles Timothy Johnson, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2121 E Harmony Rd, Unit 100, Fort Collins, CO 80528 Phone: 970-221-1000 Fax: 970-297-6860 | |
Dr. Elizabeth A Yoder, M.D. Cardiovascular Disease Medicare: Accepting Medicare Assignments Practice Location: 2637 Midpoint Dr Ste B, Fort Collins, CO 80525 Phone: 970-488-1666 Fax: 970-472-9381 |