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General NPI Number Information
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NPI Number | 1942391164
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Entity Type | Organization
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Legal Business Name | LUCIUS D. CLAY, III, M.D. PC
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1900 TATE SPRINGS RD SUITE 3
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City | LYNCHBURG
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State | VA
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Zip | 24501-1122
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Country | US
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Telephone | 434-947-3950
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Fax | 434-947-5914
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Provider Business Mailing Address
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Address Line | 1900 TATE SPRINGS RD SUITE 3
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City | LYNCHBURG
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State | VA
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Zip | 24501-1122
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Country | US
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Telephone | 434-947-3950
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Fax | 434-947-5914
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LUCIUS D CLAY III
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Credential | MD
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Telephone | 434-947-3950
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 0101234666
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License Number State | VA
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