Provider Demographics
NPI:1437572435
Name:GAERTNER PSYCHIATRIC PC
Entity Type:Organization
Organization Name:GAERTNER PSYCHIATRIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:W RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:GAERTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-372-2028
Mailing Address - Street 1:603 JEFFERSON DAVIS HWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-4436
Mailing Address - Country:US
Mailing Address - Phone:540-372-2028
Mailing Address - Fax:540-373-0945
Practice Address - Street 1:603 JEFFERSON DAVIS HWY
Practice Address - Street 2:SUITE 101
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-4436
Practice Address - Country:US
Practice Address - Phone:540-372-2028
Practice Address - Fax:540-373-0945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010350452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty