=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548497985
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | WOA IMAGING ASSOCIATES, P.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2009
-----------------------------------------------------
Last Update Date | 01/22/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1830 AMHERST ST
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22601-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-536-0057
-----------------------------------------------------
Fax | 540-667-6589
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1830 AMHERST ST
-----------------------------------------------------
City | WINCHESTER
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22601-2808
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-536-0057
-----------------------------------------------------
Fax | 540-667-6589
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OFFICE ADMINISTRATOR
-----------------------------------------------------
Name | ELLEN PAYSON-BIESCHKE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 540-667-7764
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207X00000X
-----------------------------------------------------
Taxonomy Name | Orthopaedic Surgery Physician
-----------------------------------------------------
License Number | 0101025440
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------