Healthcare Provider Details

I. General information

NPI: 1003139122
Provider Name (Legal Business Name): KATHLEEN BRELSFORD FRENCH, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2010
Last Update Date: 03/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 HAMAKER CT SUITE B104
FAIRFAX VA
22031-2238
US

IV. Provider business mailing address

3020 HAMAKER CT SUITE B104
FAIRFAX VA
22031-2238
US

V. Phone/Fax

Practice location:
  • Phone: 703-641-4877
  • Fax: 703-641-1123
Mailing address:
  • Phone: 703-641-4877
  • Fax: 703-641-1123

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number0101042074
License Number StateVA

VIII. Authorized Official

Name: DR. KATHLEEN BRELSFORD FRENCH
Title or Position: OWNER/NEUROSURGEON
Credential: M.D.
Phone: 703-641-4877