Organization
PENINSULA GASTROENTEROLOGY, PC
Active
Organization
PENINSULA GASTROENTEROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERNEST PERRY BUXTON III MD (PRESIDENT)
(757) 599-6333
Entity
Organization
Contact information
Practice address
101 PHILIP ROTH ST, NEWPORT NEWS, VA 23606-1393
(757) 599-6333
(757) 599-9425
Mailing address
101 PHILIP ROTH ST, NEWPORT NEWS, VA 23606-1393
(757) 599-6333
(757) 599-9425
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002373
ANTHEM
—
01
—
4489483
AETNA
—
01
—
550054
OPTIMAHEALTH
—
01
—
CM2099
MEDICARE RAILROAD
—
Enumeration date
06/02/2005
Last updated
07/21/2022
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