Provider Demographics
NPI:1871083402
Name:LSE FAMILY PHYSICIANS, LLC
Entity type:Organization
Organization Name:LSE FAMILY PHYSICIANS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:LOVE BRANDON
Authorized Official - Last Name:LANDRUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:662-312-8916
Mailing Address - Street 1:501 HOSPITAL RD
Mailing Address - Street 2:
Mailing Address - City:STARKVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39759-2158
Mailing Address - Country:US
Mailing Address - Phone:662-323-3162
Mailing Address - Fax:662-323-1711
Practice Address - Street 1:501 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-2158
Practice Address - Country:US
Practice Address - Phone:662-323-3162
Practice Address - Fax:662-323-1711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center