Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 0101-032350 | VA |
Y | 208600000X | Surgeon | 0101-032350 | VA |
N | 208200000X | Surgeon | 0101032350 | VA |
N | 208600000X | Surgeon | 0101032350 | VA |
N | 2086S0129X | Vascular Surgeon | 0101-032350 | VA |
N | 2086S0129X | Vascular Surgeon | 0101032350 | VA |
NPI | 1023095718 |
---|---|
Provider Name | John W. Hyslop |
First Address | North Chesterfield, VA 23235-4871 |
Second Address | North Chesterfield, VA 23235-4871 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/12/2005 |
Last Update Date | 27/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7364253 | (05) | VA |