Healthcare Provider Details

I. General information

NPI: 1841682762
Provider Name (Legal Business Name): JAMES BRYCE LOTHIAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/02/2015
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5875 BREMO ROAD, MOB SOUTH, SUITE 303 PEDIATRIC LUNG CARE
RICHMOND VA
23226
US

IV. Provider business mailing address

5875 BREMO ROAD, MOB SOUTH, SUITE 303 PEDIATRIC LUNG CARE
RICHMOND VA
23226
US

V. Phone/Fax

Practice location:
  • Phone: 804-281-8303
  • Fax: 804-287-7801
Mailing address:
  • Phone: 804-281-8303
  • Fax: 804-287-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number0101256978
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: