| Dr Calvin A Funkhouser, DO | |
|
500 J Clyde Morris Blvd Dept Of, Newport News, VA 23601-1929 | |
| (757) 612-7200 | |
| (757) 594-3184 |
| Full Name | Dr Calvin A Funkhouser |
|---|---|
| Gender | Male |
| Speciality | Student In An Organized Health Care Education/training Program |
| Location | 500 J Clyde Morris Blvd Dept Of, Newport News, Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417914789 | NPI | - | NPPES |
| 010117801 | Medicaid | VA | |
| P00263494 | Other | VA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 0110001910 (Virginia) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 0116035964 (Virginia) | Primary |
| Entity Name | Winchester Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679711261 PECOS PAC ID: 0244134021 Enrollment ID: O20031124000061 |
| Entity Name | Shenandoah Memorial Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1952417735 PECOS PAC ID: 2466360375 Enrollment ID: O20040115001156 |
| Entity Name | Page Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1326040684 PECOS PAC ID: 8426951203 Enrollment ID: O20040129000420 |
| Entity Name | Warren Memorial Hospital, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164442281 PECOS PAC ID: 2365330347 Enrollment ID: O20040310000516 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Calvin A Funkhouser, DO 68 Croatan Rd, Newport News, VA 23606-2617 Ph: (540) 421-5557 | Dr Calvin A Funkhouser, DO 500 J Clyde Morris Blvd Dept Of, Newport News, VA 23601-1929 Ph: (757) 612-7200 |