Ly T Phan, MD

NPI #1356430870 in Columbia, Missouri

Provider Information

NPI Number: 1356430870
Entity Type: Individual
Name: Ly T Phan, MD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Surgery
Credential: MD
Enumeration Date: Oct 12, 2006
Last Updated: Apr 11, 2017

Practice Location

Address: 1601 E BROADWAY
Address 2: STE 240
City: Columbia
State: Missouri
ZIP Code: 65201-8020
Phone: (573) 815-8145

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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