Basic Information
| Provider Information | |||||||||
| NPI: | 1386935708 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LUMSDEN | ||||||||
| FirstName: | KIMBERLY | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | MD, PHD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1550 RODNEY RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174089715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178468791 | ||||||||
| FaxNumber: | 7178468410 | ||||||||
| Practice Location | |||||||||
| Address1: | 1550 RODNEY RD | ||||||||
| Address2: | |||||||||
| City: | YORK | ||||||||
| State: | PA | ||||||||
| PostalCode: | 174089715 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7178468791 | ||||||||
| FaxNumber: | 7178468410 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/20/2011 | ||||||||
| LastUpdateDate: | 08/17/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD450583 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 102992667 | 05 | PA | MEDICAID | 389078FLT | 05 | PA | MEDICAID |