Judson, Preston Lyman

Judson, Preston Lyman is an individual health care provider with primary practice located at 2000 Meade Parkway , Suffolk VA 23434-4259. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Judson, Preston Lyman can be contacted via phone (757) 925-0759.

Contact Information

Primary practice address
2000 Meade Parkway Suffolk VA 23434-4259
Phone: (757) 925-0759
Fax: (757) 934-9377
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 0101032550 Virginia

Profile Details

NPI number 1790740280
LBN Legal business name Judson, Preston Lyman
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Apr 9th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790740280 NPPES
Virginia MEDICAID 6024874
Virginia MEDICAID 890583H
Virginia MEDICAID 02082828
Virginia Other 110090754

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