MEDICARE: DR. PETER C EARL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	MD43527	TN
2	207V00000X	Obstetrics & Gynecology Physician	0101-230521	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740256478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER C EARL MD

Provider Business Mailing Address
First Line	:	7194 DUVAL AVE
Second Line	:
City	:	GLOUCESTER
State	:	VA
Zip	:	23061
Country	:	US
Telephone Number	:	423-765-3645
Fax Number	:

Provider Business Practice Location Address
First Line	:	102 DMV DR
Second Line	:
City	:	KILMARNOCK
State	:	VA
Zip	:	22482-3843
Country	:	US
Telephone Number	:	804-288-4084
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/23/2006
Last Update Date	:	01/23/2026

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