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General NPI Number Information
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NPI Number | 1245421999
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Entity Type | Organization
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Legal Business Name | JOHN R. KARICKHOFF, M,D, P.C.
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 313 PARK AVE SUITE #3
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3327
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Country | US
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Telephone | 703-536-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 313 PARK AVE
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City | FALLS CHURCH
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State | VA
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Zip | 22046-3327
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Country | US
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Telephone | 703-536-2400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN R. KARICKHOFF
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Credential | M.D.
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Telephone | 703-536-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 20384
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License Number State | VA
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