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General NPI Number Information
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NPI Number | 1245218684
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Entity Type | Organization
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Legal Business Name | VIRGINIA SURGERY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 01/05/2006
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Last Update Date | 11/04/2019
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Provider Practice Location Address
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Address Line | 13135 LEE JACKSON MEMORIAL HWY STE 305
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City | FAIRFAX
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State | VA
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Zip | 22033-1907
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Country | US
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Telephone | 703-359-8640
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Fax | 703-591-6104
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Provider Business Mailing Address
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Address Line | 13135 LEE JACKSON MEMORIAL HWY STE 305
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City | FAIRFAX
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State | VA
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Zip | 22033-1907
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Country | US
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Telephone | 703-359-8640
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Fax | 703-591-6104
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | MRS. LORRIE J HALL
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Credential |
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Telephone | 703-359-8640
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number |
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State | VA
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