Healthcare Provider Details

I. General information

NPI: 1073546552
Provider Name (Legal Business Name): ARLINGTON NEPHROLOGY, PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2006
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 N GEORGE MASON DR SUITE 001
ARLINGTON VA
22205-3609
US

IV. Provider business mailing address

1715 N GEORGE MASON DR SUITE 001
ARLINGTON VA
22205-3609
US

V. Phone/Fax

Practice location:
  • Phone: 703-558-6416
  • Fax: 703-558-6657
Mailing address:
  • Phone: 703-558-6416
  • Fax: 703-558-6657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLAN JOHN GOODY
Title or Position: PRESIDENT
Credential:
Phone: 703-558-6416