Healthcare Provider Details

I. General information

NPI: 1073537676
Provider Name (Legal Business Name): VIRGINIA FERTILITY & IVF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 OLYMPIA CIR STE 201
CHARLOTTESVILLE VA
22911-3620
US

IV. Provider business mailing address

4100 OLYMPIA CIR STE 201
CHARLOTTESVILLE VA
22911-3620
US

V. Phone/Fax

Practice location:
  • Phone: 434-220-6620
  • Fax: 434-220-6621
Mailing address:
  • Phone: 434-220-6620
  • Fax: 434-220-6621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: JODY L HALLORAN
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 434-220-6626