Peacock, Philip R
Peacock, Philip R is an individual health care provider with primary practice located at 8100 Ashton Ave Suite 101, Manassas VA 20109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Peacock, Philip R can be contacted via phone (703) 257-8090.Contact Information
Primary practice address
8100 Ashton Ave Suite 101
Manassas VA 20109
Phone: (703) 257-8090
Fax: (703) 257-7822
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0102036935 | Virginia |
Profile Details
| NPI number | 1467446740 |
|---|---|
| LBN Legal business name | Peacock, Philip R |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 1st, 2005 |
| Last updated | Nov 27th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467446740 | NPPES |
| Virginia | MEDICAID | 05859361 | |
| Virginia | Other | 080175699 |
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