Provider Demographics
NPI:1043283443
Name:PHOCAS, JOHN G III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:G
Last Name:PHOCAS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Mailing Address - Street 1:17579 WARWICK BLVD
Mailing Address - Street 2:
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23603-1343
Mailing Address - Country:US
Mailing Address - Phone:757-888-0400
Mailing Address - Fax:
Practice Address - Street 1:17579 WARWICK BLVD
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23603-1343
Practice Address - Country:US
Practice Address - Phone:757-888-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012350902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
1P283758OtherMAGELLAN
266844OtherANTHEM PPO
C01884OtherMCARE GROUP
P00089632OtherMCARE RAILROAD
VA10010241Medicaid
VA327269OtherMHN
327269OtherMANAGED HEALTH NETWORK
266844OtherANTHEM BCBS
081094MOtherSENTARA OPTIMA
266844OtherBC BS
VA381660OtherMAMSI
327269OtherMANAGED HEALTH NETWORK
G81846Medicare UPIN