Provider Demographics
NPI:1831289339
Name:PIERCE, JOHN G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:PIERCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:114 NATIONWIDE DR
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24502-4271
Mailing Address - Country:US
Mailing Address - Phone:434-239-7890
Mailing Address - Fax:434-237-9222
Practice Address - Street 1:114 NATIONWIDE DR
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24502-4271
Practice Address - Country:US
Practice Address - Phone:434-239-7890
Practice Address - Fax:434-237-9222
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101059339207R00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006214029 541581185Medicaid
F99198Medicare UPIN
160001674 C03686Medicare ID - Type Unspecified