Provider Demographics
NPI:1598266744
Name:PERCY H. LO, M.D., PLLC
Entity Type:Organization
Organization Name:PERCY H. LO, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PLASTIC SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:PERCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:216-543-5749
Mailing Address - Street 1:1739 1/2 BAYOU GRANDE BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-1907
Mailing Address - Country:US
Mailing Address - Phone:216-543-5749
Mailing Address - Fax:
Practice Address - Street 1:6255 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-8431
Practice Address - Country:US
Practice Address - Phone:216-543-5749
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-23
Last Update Date:2018-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty