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General NPI Number Information
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NPI Number | 1124106455
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Entity Type | Organization
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Legal Business Name | FAIRFAX ORTHOPAEDICS, PLLC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 09/10/2008
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Provider Practice Location Address
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Address Line | 3301 WOODBURN RD STE 208
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City | ANNANDALE
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State | VA
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Zip | 22003-1200
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Country | US
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Telephone | 703-560-9495
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Fax |
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Provider Business Mailing Address
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Address Line | 3301 WOODBURN RD STE 208
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City | ANNANDALE
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State | VA
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Zip | 22003-1200
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFC MGR
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Name | JOY HARLOW
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Credential |
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Telephone | 703-560-9495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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