1720032618 NPI number — GEORGIA ANN PRESCOTT M.D.

Table of content: NATASHA SAINI (NPI 1477225944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720032618 NPI number — GEORGIA ANN PRESCOTT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRESCOTT
Provider First Name:
GEORGIA
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720032618
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
119 BULIFANTS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23188-5747
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-564-7337
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
119 BULIFANTS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23188-5709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-564-7337
Provider Business Practice Location Address Fax Number:
757-564-3205
Provider Enumeration Date:
05/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  0101026527 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 53853 . This is a "SENTARA/OPTIMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 12-02008 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1478323 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2179104 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8128041 . This is a "MAMSI/MDIPA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010126100 . This is a "VA PREMIERE HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54-1778786 . This is a "FIRST HEALTH/MAIL HANDLER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54-1778786 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54-1778786-032 . This is a "TRICARE/CHAMPUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54-1778786 . This is a "VA HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54-1778786 . This is a "MID ATLANTIC HEALTH SOLUT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 010126100 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54-1778786 . This is a "CCN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 249648 . This is a "SOUTHERN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4207833 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 153986 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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