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General NPI Number Information
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NPI Number | 1316266828
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Entity Type | Organization
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Legal Business Name | KUN FRANK LU MD PA
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Dates
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Enumeration Date | 05/24/2010
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Last Update Date | 05/24/2010
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Provider Practice Location Address
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Address Line | 2417 JENKS AVE
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City | PANAMA CITY
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State | FL
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Zip | 32405-4308
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Country | US
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Telephone | 850-270-1242
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1809
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City | LYNN HAVEN
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State | FL
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Zip | 32444-5809
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Country | US
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Telephone | 850-270-1242
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KUN FRANK LU
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Credential | M.D.
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Telephone | 850-270-1242
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | ME104290
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License Number State | FL
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