Lau Tran, MD

Individual provider Active NPI Family Medicine Physician · Lyons, IN

NPI 1063404390 · NPPES record last updated Nov 24, 2009

Key facts

NPI
1063404390
Entity type
Individual (NPI type 1)
Primary specialty
Family Medicine Physician 207Q00000X
License
01026593 (IN)
Practice address
195 East Broad St
Lyons, IN 47443-0236
Phone
(812) 659-7600
Fax
(812) 659-7601
NPI assigned
Aug 23, 2005
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
01026593INMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Major Hospital Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 01026593 IN Yes

Addresses

Primary practice location

195 East Broad St
Lyons, IN 47443-0236

Mailing address

PO Box 236
Lyons, IN 47443-0236
Phone (812) 659-7600

Other identifiers

IdentifierTypeStateIssuer
100124600MedicaidIN

Other providers in Lyons, IN

All providers in Lyons, IN · Family Medicine Physician in Indiana

Sources for this page

Verify at the official NPI Registry.