Provider Demographics
NPI:1659468924
Name:LUNA, ANTHONY D (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:D
Last Name:LUNA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:222 MAIN STREET
Mailing Address - Street 2:BOX 127
Mailing Address - City:MINNEOLA
Mailing Address - State:KS
Mailing Address - Zip Code:67865-0127
Mailing Address - Country:US
Mailing Address - Phone:620-885-4202
Mailing Address - Fax:620-885-4805
Practice Address - Street 1:222 MAIN STREET
Practice Address - Street 2:BOX 127
Practice Address - City:MINNEOLA
Practice Address - State:KS
Practice Address - Zip Code:67865-0127
Practice Address - Country:US
Practice Address - Phone:620-885-4202
Practice Address - Fax:620-885-4805
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2014-03-03
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Provider Licenses
StateLicense IDTaxonomies
KS0420309207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100341990AMedicaid
KSD74115Medicare UPIN
KS100341990AMedicaid