Provider Demographics
NPI:1275150948
Name:JUDY, ANDREW LEE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:LEE
Last Name:JUDY
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
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Mailing Address - Street 1:2317 BROADWAY AVE SW APT E
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24014-1667
Mailing Address - Country:US
Mailing Address - Phone:703-650-8228
Mailing Address - Fax:
Practice Address - Street 1:101 ELM AVE SE
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24013-2222
Practice Address - Country:US
Practice Address - Phone:888-985-8483
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant