Organization
VIRGINIA WOMENS CENTER FOR AESTHETICS
Active
Other names
Virginia Gynecology Surgical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK AYOUB MD (CEO AND PRESIDENT)
(703) 858-5399
Entity
Organization
Contact information
Practice address
19490 SANDRIDGE WAY STE 360, LEESBURG, VA 20176-3467
(703) 858-5399
(703) 858-5699
Mailing address
19490 SANDRIDGE WAY STE 360, LEESBURG, VA 20176-3467
(703) 858-5399
(703) 858-5699
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790836690
JACK PETE AYOUB
VA
01
—
1942440953
VIRGINIA OBSTETRICS & GYNECOLOGY PC
VA
Enumeration date
04/08/2020
Last updated
11/27/2023
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