Ly, Thomas C

Ly, Thomas C is an individual health care provider with primary practice located at 101 Civic Center Ln , Lake Havasu City AZ 86403-5607. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Ly, Thomas C can be contacted via phone (928) 854-0002.

Contact Information

Primary practice address
101 Civic Center Ln Lake Havasu City AZ 86403-5607
Phone: (928) 854-0002
Fax: (928) 453-0885
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 45537 Arizona

Profile Details

NPI number 1891007787
LBN Legal business name Ly, Thomas C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 8th, 2010
Last updated Jan 18th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891007787 NPPES
Arizona MEDICAID 666099

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