Provider Demographics
NPI:1891098620
Name:THE FAMILY DOCTOR'S OFFICE PLC
Entity Type:Organization
Organization Name:THE FAMILY DOCTOR'S OFFICE PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:KEENAN
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-723-9889
Mailing Address - Street 1:440 W JUBAL EARLY DR STE 120
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6319
Mailing Address - Country:US
Mailing Address - Phone:540-723-9889
Mailing Address - Fax:540-723-9809
Practice Address - Street 1:440 W JUBAL EARLY DR STE 120
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-6319
Practice Address - Country:US
Practice Address - Phone:540-723-9889
Practice Address - Fax:540-723-9809
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102037125207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5630235000Medicaid
272773OtherBCBS
080006803Medicare PIN
F19855Medicare UPIN