# LOUDOUN MEDICAL GROUP, PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** LOUDOUN MEDICAL GROUP, PC
- **Other names:** LMG Advanced Imaging Services
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1326754052
- **Legal business name:** LOUDOUN MEDICAL GROUP, PC
- **Authorized official:** MARY BETH TAMASY (CEO)
- **Authorized official phone:** (703) 737-6010

## Contact information

- **Practice address:** 19500 SANDRIDGE WAY, SUITE 460, LEESBURG, VA 20176-3694
- **Practice address phone:** (571) 206-0767
- **Practice address fax:** (571) 384-4453
- **Mailing address:** 224 D CORNWALL STREET NW, SUITE 403, LEESBURG, VA 20176-2704
- **Mailing address phone:** (703) 737-6010
- **Mailing address fax:** (703) 443-8643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/26/2023
- **Last updated:** 04/10/2023