Provider Demographics
NPI:1831243542
Name:HURT, GEORGE SAMUEL (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:SAMUEL
Last Name:HURT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CLEVELAND AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3700
Mailing Address - Country:US
Mailing Address - Phone:276-634-5000
Mailing Address - Fax:276-634-5229
Practice Address - Street 1:101 CLEVELAND AVE
Practice Address - Street 2:SUITE C
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3700
Practice Address - Country:US
Practice Address - Phone:276-634-5000
Practice Address - Fax:276-634-5229
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01010332782088P0231X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric Urology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA2292300 AOtherPIEDMONT STONE PHYSICIAN
VA1831243542Medicaid
VA7554222Medicaid
VA2292300 AOtherPIEDMONT STONE PHYSICIAN
VAD73297Medicare UPIN