E MICHAEL LUCERO, MD PC
Medical Practice at Highland Ave, Phoenix, AZ

License number
Arizona 21440
Category
Medical Practice
Type
Adult Reconstructive Orthopaedic Surgery
Owner
Name: MARCY WILKINSON
Title: PRACTICE MANAGER
Phone: (602) 667-6640
Address
Address
2222 E Highland Ave SUITE 425, Phoenix, AZ 85016
National Provider ID: 1093066193
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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E. MICHAEL LUCERO, M.D., PC

2222 E Highland #425, Phoenix, AZ 85016

Status:
Inactive
Inactive reason:
Ad-dissolved-file annual report
Registration:
Apr 21, 1994
Inactive since:
Mar 30, 2012
State ID:
-0716398-7
Expiration:
PERPETUAL
President/ceo:
E Michael Lucero Md (President/ceo), 2222 E Highland #425, Phoenix, AZ 85016 (Physical)
Agent:
David R Frazer,3101 N Central Ave #1600, Phoenix, AZ 85012 (Physical)
Business type:
HEALTH CARE

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