Provider Demographics
NPI:1912048984
Name:CHARLES W LOMAX MD PA
Entity Type:Organization
Organization Name:CHARLES W LOMAX MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:W
Authorized Official - Last Name:LOMAX
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:336-274-1200
Mailing Address - Street 1:311 W WENDOVER AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27408-8447
Mailing Address - Country:US
Mailing Address - Phone:336-662-8185
Mailing Address - Fax:336-665-6188
Practice Address - Street 1:311 W WENDOVER AVE
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-8447
Practice Address - Country:US
Practice Address - Phone:336-662-8185
Practice Address - Fax:336-665-6188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-10
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC16415207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2309293Medicare ID - Type UnspecifiedCIGNA MEDICARE NC