Provider Demographics
NPI:1710565825
Name:FORD, COURTNEY CAMILLE (MD)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:CAMILLE
Last Name:FORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 S WASHINGTON ST STE 330
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-4291
Mailing Address - Country:US
Mailing Address - Phone:703-940-3364
Mailing Address - Fax:703-717-4055
Practice Address - Street 1:700 S WASHINGTON ST STE 330
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-4291
Practice Address - Country:US
Practice Address - Phone:703-940-3364
Practice Address - Fax:703-717-4055
Is Sole Proprietor?:No
Enumeration Date:2021-03-30
Last Update Date:2025-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101285180207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology