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General NPI Number Information
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NPI Number | 1245791458
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Entity Type | Individual
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Provider Name | KURTIS DAVID CARLOCK MD
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Gender | Male
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Dates
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Enumeration Date | 03/29/2019
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Last Update Date | 08/12/2025
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Provider Practice Location Address
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Address Line | 1715 NORTH GEORGE MASON DR MEDICAL OFFICES D, SUITE 504
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City | ARLINGTON
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State | VA
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Zip | 22205
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Country | US
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Telephone | 703-525-2200
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Fax |
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Provider Business Mailing Address
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Address Line | 1715 NORTH GEORGE MASON DRIVE MEDICAL OFFICES D, SUITE 504
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City | ARLINGTON
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State | VA
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Zip | 22205
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Country | US
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Telephone | 703-525-2200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 0101284933
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License Number State | VA
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