Ly T Phan is a Surgery in Saint Louis, Missouri. Ly T Phan practices all healthcare services and medical treatments related to Surgery. The NPI Number for Ly T Phan is 1356430870. The last update date is 2017-04-11.
Ly T Phan's current location address is 670 Mason Ridge Center Dr, Saint Louis, Missouri. You can contact this provider via phone number 5738158145 and fax number 5738153832. The mailing address for Ly T Phan is 670 Mason Ridge Center Dr, Saint Louis, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Ly T Phan |
|---|---|
| Address | 670 Mason Ridge Center Dr, Saint Louis, Missouri |
| Phone Number | 5738158145 |
| Fax Number | 5738153832 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1356430870 |
|---|---|
| Provider Enumeration Date | 2006-10-12 |
| Last Updated Date | 2017-04-11 |
Provider Mailing Address Detail
| Address | 670 Mason Ridge Center Dr |
|---|---|
| City | Saint Louis |
| State | Missouri (MO) |
| Post Code | 631418573 |
| Phone Number | 5738158145 |
| Fax Number | 5738153832 |
Provider's Primary Taxonomy Detail
| Speciality | Surgery |
|---|---|
| Taxonomy | 208600000X |
| Licence No | 2005030724 |
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Definition: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 207505603 | MO | -- |
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What is the unique identification code assigned to Ly T Phan by the Centers for Medicare & Medicaid Services?
The Ly T Phan has been issued the NPI (National Provider Identifier) 1356430870. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the Ly T Phan located?
The Ly T Phan is located at 670 Mason Ridge Center Dr, Saint Louis, MO 631418573.
What is Ly T Phan's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Ly T Phan is Surgery, and the corresponding taxonomy classification code for this specialized field is 208600000X.
On what date did the Centers for Medicare & Medicaid Services assign the 1356430870 to Ly T Phan?
The Centers for Medicare & Medicaid Services assigned the 1356430870 to Ly T Phan on 2006-10-12.
As of what date were the details pertaining to Ly T Phan last refreshed?
The information related to the Ly T Phan, including its address, specialty, and other relevant details, was last updated on 2017-04-11.
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