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General NPI Number Information
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NPI Number | 1063437903
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Entity Type | Organization
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Legal Business Name | FAIR OAKS IMAGING CENTER, PC
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 04/21/2023
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Provider Practice Location Address
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Address Line | 4001 FAIR RIDGE DRIVE SUITE 103
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City | FAIRFAX
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State | VA
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Zip | 22033-2917
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Country | US
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Telephone | 703-385-5203
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Fax | 703-385-3058
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Provider Business Mailing Address
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Address Line | P.O BOX 207431
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City | DALLAS
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State | TX
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Zip | 75320-7431
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Country | US
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Telephone | 703-726-1201
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Fax | 703-726-1053
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Authorized Official
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Title or Position | CEO
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Name | DR. JEFFREY ATKIN
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Credential | MBA, MIS, CPHIMS
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Telephone | 703-726-1201
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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