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General NPI Number Information
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NPI Number | 1376766816
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Entity Type | Individual
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Provider Name | JOHN PHILLIP ESSEPIAN III M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2007
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Last Update Date | 02/24/2019
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Provider Practice Location Address
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Address Line | 3031 JAVIER RD STE 300
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City | FAIRFAX
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State | VA
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Zip | 22031-4638
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Country | US
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Telephone | 703-698-8880
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Fax | 703-698-8884
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Provider Business Mailing Address
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Address Line | 3031 JAVIER RD STE 300
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City | FAIRFAX
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State | VA
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Zip | 22031-4637
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Country | US
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Telephone | 703-698-8880
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Fax | 703-698-8884
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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 | 207WX0009X
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Taxonomy Name | Glaucoma Specialist (Ophthalmology) Physician
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License Number | 0101051247
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101051247
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License Number State | VA
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