Healthcare Provider Details

I. General information

NPI: 1548353501
Provider Name (Legal Business Name): VIRGINIA PHYSICIAN ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 12/19/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1625 N GEORGE MASON DR SUITE 415
ARLINGTON VA
22205-3683
US

IV. Provider business mailing address

1625 N GEORGE MASON DR SUITE 415
ARLINGTON VA
22205-3683
US

V. Phone/Fax

Practice location:
  • Phone: 703-717-4200
  • Fax: 703-717-4201
Mailing address:
  • Phone: 703-717-4200
  • Fax: 703-717-4201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code2086S0122X
TaxonomyPlastic and Reconstructive Surgery Physician
License Number
License Number State
# 7
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State
# 8
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER D O'BRIEN
Title or Position: VICE PRESIDENT, PHYSICIAN SERVICES
Credential:
Phone: 703-558-6653