Provider Demographics
NPI:1669466181
Name:NEATROUR, GEORGE PEYTON (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PEYTON
Last Name:NEATROUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 FIRST COLONIAL RD
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23454-2217
Mailing Address - Country:US
Mailing Address - Phone:757-425-5550
Mailing Address - Fax:757-412-2606
Practice Address - Street 1:1201 FIRST COLONIAL RD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23454-2217
Practice Address - Country:US
Practice Address - Phone:757-425-5550
Practice Address - Fax:757-412-2606
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101039331207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006343350Medicaid
VAC47288Medicare UPIN
VA0317130001Medicare NSC
VA006343350Medicaid