Provider Demographics
NPI:1851392161
Name:L.E.A. LUMSDEN EUBANK ASSOCIATES
Entity Type:Organization
Organization Name:L.E.A. LUMSDEN EUBANK ASSOCIATES
Other - Org Name:FAMILY MEDICAL PRACTITIONERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCTS MGR
Authorized Official - Prefix:
Authorized Official - First Name:LIZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:WIRTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-460-1207
Mailing Address - Street 1:1147 INDEPENDENCE BLVD.
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23455
Mailing Address - Country:US
Mailing Address - Phone:757-460-1207
Mailing Address - Fax:757-460-2136
Practice Address - Street 1:1147 INDEPENDENCE BLVD.
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23455
Practice Address - Country:US
Practice Address - Phone:757-460-1207
Practice Address - Fax:757-460-2136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA207V00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty