Provider Demographics
NPI:1417095951
Name:LOMAX, PEGGY JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:PEGGY
Middle Name:JEAN
Last Name:LOMAX
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6845 ELM STREET
Mailing Address - Street 2:
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101-0000
Mailing Address - Country:US
Mailing Address - Phone:703-442-8889
Mailing Address - Fax:202-298-6327
Practice Address - Street 1:6845 ELM STREET
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:703-442-8889
Practice Address - Fax:202-298-6327
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-04
Last Update Date:2008-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0466472084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA71-4407-5Medicaid
E60103Medicare UPIN
VA71-4407-5Medicaid