Provider Demographics
NPI:1659977643
Name:LUNSFORD, ANDREW D (CMS)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:D
Last Name:LUNSFORD
Suffix:
Gender:M
Credentials:CMS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5611 GALLIA ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:OH
Mailing Address - Zip Code:45662-5520
Mailing Address - Country:US
Mailing Address - Phone:740-529-0083
Mailing Address - Fax:
Practice Address - Street 1:5611 GALLIA ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-5520
Practice Address - Country:US
Practice Address - Phone:740-529-0083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-07
Last Update Date:2020-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator