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General NPI Number Information
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NPI Number | 1588876767
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Entity Type | Organization
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Legal Business Name | ANNIE LUY M.D. PA
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1407 E RACE AVE
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City | SEARCY
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State | AR
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Zip | 72143-4659
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Country | US
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Telephone | 501-279-1472
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Fax | 501-268-4385
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Provider Business Mailing Address
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Address Line | 1407 E RACE AVE
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City | SEARCY
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State | AR
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Zip | 72143-4659
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Country | US
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Telephone | 501-279-1472
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Fax | 501-268-4385
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Authorized Official
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Title or Position | DOCTOR
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Name | ANNIE LUY
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Credential | MD
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Telephone | 501-279-1472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | E0465
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License Number State | AR
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