Provider Demographics
NPI:1952141277
Name:DOCTALK LLC
Entity type:Organization
Organization Name:DOCTALK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAEEQ
Authorized Official - Middle Name:A
Authorized Official - Last Name:BUTT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-400-5314
Mailing Address - Street 1:45929 MARIES RD STE 100
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20166-9299
Mailing Address - Country:US
Mailing Address - Phone:703-400-5314
Mailing Address - Fax:
Practice Address - Street 1:45929 MARIES RD STE 100
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20166-9299
Practice Address - Country:US
Practice Address - Phone:703-400-5314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty