Provider Demographics
NPI:1730674722
Name:FILHO, LUIZ M DA COSTA LIMA (MD)
Entity Type:Individual
Prefix:
First Name:LUIZ
Middle Name:M DA COSTA LIMA
Last Name:FILHO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:LUIZ
Other - Middle Name:MOREIRA DA COSTA
Other - Last Name:LIMA FILHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2500 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4500
Mailing Address - Country:US
Mailing Address - Phone:601-984-5914
Mailing Address - Fax:601-984-5915
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-5914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-22
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MS31554207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program