Provider Demographics
NPI:1972530210
Name:PL PHYSICIANS, INC.
Entity type:Organization
Organization Name:PL PHYSICIANS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DANA
Authorized Official - Middle Name:P
Authorized Official - Last Name:TATE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-371-4488
Mailing Address - Street 1:4550 EMPIRE CT.
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22408-1939
Mailing Address - Country:US
Mailing Address - Phone:540-361-1800
Mailing Address - Fax:540-361-1103
Practice Address - Street 1:4550 EMPIRE CT.
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22408-1939
Practice Address - Country:US
Practice Address - Phone:540-361-1800
Practice Address - Fax:540-361-1103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-26
Last Update Date:2014-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101237959208000000X
VA0101043865208000000X
VA0101241779208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC10131Medicare PIN
VA00X369P01Medicare PIN