Provider Demographics
NPI:1356921076
Name:GUASTELLA, LILY FRANCESCA (MD)
Entity type:Individual
Prefix:
First Name:LILY
Middle Name:FRANCESCA
Last Name:GUASTELLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LILY
Other - Middle Name:FRANCESCA
Other - Last Name:GUASTELLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2302 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72034-6297
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17280 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MS
Practice Address - Zip Code:39095-6614
Practice Address - Country:US
Practice Address - Phone:662-834-1857
Practice Address - Fax:662-834-1859
Is Sole Proprietor?:No
Enumeration Date:2021-04-08
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-15684207Q00000X
390200000X
MS30437207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program