Provider Demographics
NPI:1114910304
Name:HIRSH, PHILIP R JR (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:R
Last Name:HIRSH
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:241 GREENHOUSE RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:24450-3717
Mailing Address - Country:US
Mailing Address - Phone:540-463-3141
Mailing Address - Fax:540-464-4051
Practice Address - Street 1:241 GREENHOUSE RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:VA
Practice Address - Zip Code:24450-3717
Practice Address - Country:US
Practice Address - Phone:540-463-3141
Practice Address - Fax:540-464-4051
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010176122084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
E18260Medicare UPIN