Provider Demographics
NPI:1851472328
Name:FAUQUIER EAR NOSE AND THROAT CONSULTANTS, PLC
Entity Type:Organization
Organization Name:FAUQUIER EAR NOSE AND THROAT CONSULTANTS, PLC
Other - Org Name:FAUQUIER ENT CONSULTANTS, PLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:A
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-347-0505
Mailing Address - Street 1:550 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186
Mailing Address - Country:US
Mailing Address - Phone:540-347-0505
Mailing Address - Fax:540-347-5224
Practice Address - Street 1:550 HOSPITAL DRIVE
Practice Address - Street 2:
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-347-0505
Practice Address - Fax:540-347-5224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232269207Y00000X
VA0101237204207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAI41413Medicare UPIN
VAG51920Medicare UPIN
VA008494F44Medicare ID - Type UnspecifiedCHRISTOPHER Y. CHANG MD