Provider Demographics
NPI:1093777633
Name:GEORGE T HOCKER MD
Entity Type:Organization
Organization Name:GEORGE T HOCKER MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:HOCKER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-777-4959
Mailing Address - Street 1:209 OLD WATERFORD ROAD NW
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176
Mailing Address - Country:US
Mailing Address - Phone:703-777-4959
Mailing Address - Fax:703-777-8364
Practice Address - Street 1:209 OLD WATERFORD ROAD NW
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176
Practice Address - Country:US
Practice Address - Phone:703-777-4959
Practice Address - Fax:703-777-8364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101016585208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5610966Medicaid
VA5610966Medicaid