Individual
DR. GEORGE WORTHY PEGRAM III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
801 POINDEXTER ST STE 115, CHESAPEAKE, VA 23324-2358
(757) 545-3930
(757) 545-0193
Mailing address
801 POINDEXTER ST STE 115, CHESAPEAKE, VA 23324-2358
(757) 545-3930
(757) 545-0193
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0601001900
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009238182
—
VA
01
—
5452
DAVIS VISION
VA
01
—
940935
EYEMED VISION CARE
VA
Enumeration date
12/05/2005
Last updated
09/13/2012
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