Healthcare Provider Details

I. General information

NPI: 1558342840
Provider Name (Legal Business Name): ARTHRITIS & SPORTS ORTHOPAEDICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 07/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21475 RIDGETOP CIRCLE SUITE 150
STERLING VA
20166
US

IV. Provider business mailing address

21475 RIDGETOP CIRCLE SUITE 150
STERLING VA
20166
US

V. Phone/Fax

Practice location:
  • Phone: 703-444-5000
  • Fax: 703-444-4999
Mailing address:
  • Phone: 703-444-5000
  • Fax: 703-444-4999

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number0101052246
License Number StateVA

VIII. Authorized Official

Name: DR. RANDALL S PEYTON
Title or Position: PRESIDENT
Credential: MD
Phone: 703-444-5000