Individual provider · Type 1 NPI

Ly T. Phan, MD

Surgery Physician · Columbia, MO

NPI number 1356430870 Active

Practice location

1601 E Broadway, Ste 240
Columbia, MO 65201-8020

Call (573) 815-8145 Map

Fax (573) 815-3832

Mailing address

670 Mason Ridge Center Dr, Ste 300
St. Louis, MO 63141-8573

Specialties and licenses

TaxonomyCodeLicense
Surgery Physician Primary 208600000X2005030724 (MO)

Surgery Physician: A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasin…

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About NPI 1356430870

Ly T. Phan, MD's National Provider Identifier is 1356430870, issued on Oct 12, 2006. The primary taxonomy on file is Surgery Physician (208600000X), and the practice location is in Columbia, MO. The record was last updated on Apr 11, 2017.