Provider Demographics
NPI:1780142034
Name:PETER LUX, MD, PLLC
Entity type:Organization
Organization Name:PETER LUX, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:LUX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-635-0973
Mailing Address - Street 1:10645 N ORACLE RD STE 121-284
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-9387
Mailing Address - Country:US
Mailing Address - Phone:312-635-0973
Mailing Address - Fax:803-291-5906
Practice Address - Street 1:15810 S 42ND ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-7409
Practice Address - Country:US
Practice Address - Phone:312-635-0973
Practice Address - Fax:803-291-5906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-06
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty