Individual
CLAY ASHLEY LOUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11020 HULL STREET RD, MIDLOTHIAN, VA 23112-3200
(804) 744-6310
Mailing address
5000 COX RD, GLEN ALLEN, VA 23060-9263
(804) 968-5700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101231696
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010003211
—
VA
Enumeration date
02/17/2006
Last updated
02/17/2022
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