Provider Demographics
NPI:1912107152
Name:LESTER, DOROTHY J (PA-C)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:J
Last Name:LESTER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 JOHNSTON WILLIS DR 200
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23235-4871
Mailing Address - Country:US
Mailing Address - Phone:804-320-2705
Mailing Address - Fax:804-330-2433
Practice Address - Street 1:2602 BUFORD RD
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23235-3422
Practice Address - Country:US
Practice Address - Phone:804-272-8806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-24
Last Update Date:2015-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110002551363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014841V68Medicare PIN
VA014433V21Medicare PIN
VA014434V20Medicare PIN
VA014435V01Medicare PIN