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DR. JOHNNY TAN LU M.D.
NPI 1679863278
Specialist in Saint Louis, MO

Active since April 15, 2011
12647 OLIVE BLVD, SAINT LOUIS, MO 63141(800) 325-3982(877) 685-9866 Get Directions Write a Review

NPPES record last updated: April 15, 2011. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Johnny Tan Lu M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JOHNNY TAN LU M.D. (NPI 1679863278) is an individual specialist in Saint Louis, Missouri, licensed in Virginia (0101221438) and active in the NPI registry since April 2011.

NPPES Registry Identity

NPI1679863278
Entity TypeIndividualMale
Primary Taxonomy174400000X
Provider Legal NameDR. JOHNNY TAN LUCredential: M.D.
Location Address12647 OLIVE BLVDSaint Louis, MO 63141-6393
Mailing Address12647 Olive BlvdSaint Louis, MO 63141-6393 · (800) 325-3982 · Fax (877) 685-9866
Phone(800) 325-3982
Fax(877) 685-9866
Sole ProprietorYes
Enumeration DateApril 15, 2011
✔ NPI 1679863278 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in VA · 0101221438
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
12647 OLIVE BLVD, Saint Louis, MO 63141
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. RUTH SUSAN ROSENSTEIN LCSW
Behavior Analyst
12647 OLIVE BLVD, SUITE 600
SAINT LOUIS, MO 63141
St. Louis County (180) 032-5398
SHARON DUCKWORTH
Social Worker (Clinical)
12647 OLIVE BLVD, SUITE 600
SAINT LOUIS, MO 63141
St. Louis County (520) 682-3182
MS. CAROL JO TALIAFERRO LCSW
Social Worker (Clinical)
12647 OLIVE BLVD, SUITE 600
SAINT LOUIS, MO 63141
St. Louis County (314) 744-4100
DR. WILLIAM CONNOR PH.D.
Psychologist
12647 OLIVE BLVD, SUITE 600
SAINT LOUIS, MO 63141
St. Louis County (877) 984-8285
MR. ROBERT FRED VANDEBORNE
Radiologic Technologist
12647 OLIVE BLVD, SUITE 600
SAINT LOUIS, MO 63141
St. Louis County (800) 325-3982
MS. DENISE TAYLOR DARDEN NNP
Nurse Practitioner (Neonatal)
12647 OLIVE BLVD
SAINT LOUIS, MO 63141
St. Louis County (800) 325-3982
MRS. AUDREY MARY HYLAND CRNA
Registered Nurse
12647 OLIVE BLVD
SAINT LOUIS, MO 63141
St. Louis County (314) 744-4247
MARK NEUENSCHWANDER
Family Medicine
12647 OLIVE BLVD, SUITE 600
SAINT LOUIS, MO 63141
St. Louis County (800) 325-3982

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Johnny Lu's NPI number?

The NPI number for Johnny Lu is 1679863278. It was assigned to this individual provider in the NPPES registry on April 15, 2011.

Where is Johnny Lu located?

Johnny Lu practices at 12647 Olive Blvd, Saint Louis, MO 63141. The listed phone number is (800) 325-3982.

What is Johnny Lu's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Johnny Lu was last updated on April 15, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.