Provider Demographics
NPI:1326099656
Name:LOU, LILY J (MD)
Entity Type:Individual
Prefix:DR
First Name:LILY
Middle Name:J
Last Name:LOU
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3340 PROVIDENCE DR
Mailing Address - Street 2:SUITE 366
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-4616
Mailing Address - Country:US
Mailing Address - Phone:907-563-3026
Mailing Address - Fax:907-562-6445
Practice Address - Street 1:3340 PROVIDENCE DR
Practice Address - Street 2:SUITE 366
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4616
Practice Address - Country:US
Practice Address - Phone:907-563-3026
Practice Address - Fax:907-562-6445
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-09
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Provider Licenses
StateLicense IDTaxonomies
AK48882080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD4756Medicaid