MEDICARE: FAIR OAKS ORTHO, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1518626480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAIR OAKS ORTHO, PLLC

Provider Business Mailing Address
First Line	:	3998 FAIR RIDGE DR STE 100-A
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2907
Country	:	US
Telephone Number	:	703-591-0077
Fax Number	:

Provider Business Practice Location Address
First Line	:	3998 FAIR RIDGE DR STE 100
Second Line	:
City	:	FAIRFAX
State	:	VA
Zip	:	22033-2946
Country	:	US
Telephone Number	:	703-591-0077
Fax Number	:	703-591-0080

Authorized Official
Title or Position	:	OWNER
Name	:	DR. STEPHEN W POURNARAS
Credential	:	MD
Telephone Number	:	703-591-0077

Provider Enumeration Date	:	12/08/2021
Last Update Date	:	04/06/2026

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