Provider Demographics
NPI:1982624862
Name:HARRINGTON, WILLIAM GORE (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:GORE
Last Name:HARRINGTON
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:PO BOX 999
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-0999
Mailing Address - Country:US
Mailing Address - Phone:804-594-0125
Mailing Address - Fax:
Practice Address - Street 1:14415 JUSTICE RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-6908
Practice Address - Country:US
Practice Address - Phone:804-594-0125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101031487207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA202167532OtherUNITED HEALTHCARE
VA1571542OtherCIGNA
VA96261OtherOPTIMA
VA202167532OtherGREAT WEST
VA179169OtherANTHEM
VA4397094OtherAETNA
VA96261OtherOPTIMA
VAD73389Medicare UPIN