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General NPI Number Information
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NPI Number | 1861419632
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Entity Type | Individual
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Provider Name | ANNIE T LUY M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 07/08/2007
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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 | PO BOX 1424
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City | SEARCY
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State | AR
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Zip | 72145-1424
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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 |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | E0465
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License Number State | AR
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