Provider Demographics
NPI:1942440953
Name:VIRGINIA OBSTETRICS & GYNECOLOGY PC
Entity Type:Organization
Organization Name:VIRGINIA OBSTETRICS & GYNECOLOGY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:PETE
Authorized Official - Last Name:AYOUB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-858-5599
Mailing Address - Street 1:44035 RIVERSIDE PKWY # 435
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:VA
Mailing Address - Zip Code:20176-8260
Mailing Address - Country:US
Mailing Address - Phone:703-858-5599
Mailing Address - Fax:703-858-5699
Practice Address - Street 1:44035 RIVERSIDE PKWY # 435
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:VA
Practice Address - Zip Code:20176-8260
Practice Address - Country:US
Practice Address - Phone:703-858-5599
Practice Address - Fax:703-858-5699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2009-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101244378207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty