Augustin Igulu Lukwango

Primary specialty

ContractorTaxonomy code 171W00000X

License

BH4674 Issued in AZ

Practice address

994 S Harrison Road
Tucson, AZ 85748

Phone

(520) 721-1887

Fax

(520) 721-0069

NPI assigned

Jul 27, 2015

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Devereux Foundation

  • Adolescent and Children Mental Health Clinic/Center
  • Phoenix, AZ
  • NPI 1306939368
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1629453170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 E 25TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857115682",
            "telephone_number": "520-312-0747",
            "fax_number": "520-721-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "994 S HARRISON ROAD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "85748",
            "telephone_number": "520-721-1887",
            "fax_number": "520-721-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IGULU LUKWANGO",
        "first_name": "AUGUSTIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-07-27",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "AZ",
            "license": "BH4674",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shahla Ighani, MD
• Erica Iglesias
• Jolene Ignacio, R.N.
• William B Ignatoff, M.D.
• Rita Iguado
• Igulu Social Assistance Services LLC
• Twafika Gabriel Igulu
• Ike B. Gorman DPM., PC
• Barbara Sue Ikner
• Adena R Iles, RDN

• Contractor in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Contractor in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.