Individual
DR. PHONG LUU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
5404 SW LEE BLVD, LAWTON, OK 73505-9695
(580) 355-5242
Mailing address
5404 SW LEE BLVD, LAWTON, OK 73505-9695
(580) 355-5242
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5772
OK
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2014
Last updated
09/06/2016
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