1922388685 NPI number — MS. VIRGINIA BLAIR LOUGEE M.S.

Table of content: MS. VIRGINIA BLAIR LOUGEE M.S. (NPI 1922388685)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922388685 NPI number — MS. VIRGINIA BLAIR LOUGEE M.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOUGEE
Provider First Name:
VIRGINIA
Provider Middle Name:
BLAIR
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LOUGEE
Provider Other First Name:
GINNY
Provider Other Middle Name:
BLAIR
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
VIRGINIA LOUGEE
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1922388685
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
210 BAY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWMARKET
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03857-1728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-395-8220
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
55 MAIN ST STE 413
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEWMARKET
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03857-4201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-624-6895
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2011

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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