Healthcare Provider Details
I. General information
NPI: 1093777633
Provider Name (Legal Business Name): GEORGE T HOCKER MD
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
209 OLD WATERFORD ROAD NW
LEESBURG VA
20176
US
IV. Provider business mailing address
209 OLD WATERFORD ROAD NW
LEESBURG VA
20176
US
V. Phone/Fax
- Phone: 703-777-4959
- Fax: 703-777-8364
- Phone: 703-777-4959
- Fax: 703-777-8364
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208D00000X |
| Taxonomy | General Practice Physician |
| License Number | 0101016585 |
| License Number State | VA |
VIII. Authorized Official
Name: DR.
GEORGE
T
HOCKER
Title or Position: OWNER
Credential: MD
Phone: 703-777-4959