Healthcare Provider Details

I. General information

NPI: 1669482600
Provider Name (Legal Business Name): SARAH P. BRANNON OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12100 KENNEDY LANE SUITE 206
FREDERICKSBURG VA
22407
US

IV. Provider business mailing address

12100 KENNEDY LANE SUITE 206
FREDERICKSBURG VA
22407
US

V. Phone/Fax

Practice location:
  • Phone: 540-785-3937
  • Fax: 540-785-5498
Mailing address:
  • Phone: 540-785-3937
  • Fax: 540-785-5498

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618000074
License Number StateVA

VIII. Authorized Official

Name: DR. SARAH PILAT BRANNON
Title or Position: PRESIDENT/OPTOMETRIST
Credential: OD
Phone: 540-785-3937