Provider Demographics
NPI:1124609904
Name:GUNNELS, LUCAS W (MD)
Entity type:Individual
Prefix:
First Name:LUCAS
Middle Name:W
Last Name:GUNNELS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 CAMPUS PL
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-2308
Mailing Address - Country:US
Mailing Address - Phone:502-253-4924
Mailing Address - Fax:502-489-5705
Practice Address - Street 1:BHMG INTERNAL MEDICINE & PEDS. - CRESTWOOD
Practice Address - Street 2:7101 W. HIGHWAY 22
Practice Address - City:CRESTWOOD
Practice Address - State:KY
Practice Address - Zip Code:40014
Practice Address - Country:US
Practice Address - Phone:502-241-6567
Practice Address - Fax:502-241-5083
Is Sole Proprietor?:No
Enumeration Date:2021-04-14
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY60855207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program