1922051119 NPI number — DR. WILLIAM BARTLEY HOSICK MD

Table of content: DR. WILLIAM BARTLEY HOSICK MD (NPI 1922051119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922051119 NPI number — DR. WILLIAM BARTLEY HOSICK MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOSICK
Provider First Name:
WILLIAM
Provider Middle Name:
BARTLEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOSICK
Provider Other First Name:
W. BARTLEY
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1922051119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 715868
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19171-5868
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
804-915-1910
Provider Business Mailing Address Fax Number:
804-968-1803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8644 SUDLEY RD
Provider Second Line Business Practice Location Address:
SUITE 308
Provider Business Practice Location Address City Name:
MANASSAS
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20110-4400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-369-9070
Provider Business Practice Location Address Fax Number:
703-369-9240
Provider Enumeration Date:
05/18/2006

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: 207XS0114X , with the licence number:  0101048098 , 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: 200023291 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05170001 . This is a "CAREFIRST BLUECHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 176909 . This is a "HEALTHKEEPERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 314817 . This is a "MAMSI LIFE & HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 176909 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 287790 . This is a "AMERIGROUP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4380676 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 544951 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6403239 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 719404007 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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