| Phuong Lu DO PA | |
|
1201 Monument Rd Suite 201 Jacksonville FL 32225 | |
| (904) 727-5151 | |
| (904) 727-5180 |
| Full Name | Phuong Lu DO PA |
|---|---|
| Speciality | Internal Medicine |
| Location | 1201 Monument Rd, Jacksonville, Florida |
| Authorized Official Name and Position | Nam-phuong T Lu (PRESIDENT) |
| Authorized Official Contact | 9047275151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Phuong Lu DO PA Po Box 550937 Jacksonville FL 32255-0937 Ph: (904) 727-5151 | Phuong Lu DO PA 1201 Monument Rd Suite 201 Jacksonville FL 32225 Ph: (904) 727-5151 |
| NPI Number | 1477798734 |
|---|---|
| Provider Enumeration Date | 12/15/2008 |
| Last Update Date | 09/18/2013 |
| Medicare PECOS PAC ID | 7618034323 |
|---|---|
| Medicare Enrollment ID | O20090325000319 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477798734 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | OS 8549 (Florida) | Primary |
| Provider Name | Nam-phuong T Lu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356374946 PECOS PAC ID: 7719044429 Enrollment ID: I20090325000312 |
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