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General NPI Number Information
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NPI Number | 1659721363
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Entity Type | Organization
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Legal Business Name | JOHN DU OD PC
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Dates
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Enumeration Date | 06/14/2016
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 10301 NEW GUINEA RD
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City | FAIRFAX
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State | VA
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Zip | 22032-8085
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Country | US
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Telephone | 703-794-5119
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Fax | 201-298-8085
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Provider Business Mailing Address
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Address Line | 10301 NEW GUINEA RD
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City | FAIRFAX
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State | VA
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Zip | 22032-8085
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Country | US
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Telephone | 703-794-5119
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Fax | 201-298-8085
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Authorized Official
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Title or Position | OWNER
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Name | JOHN DU
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Credential |
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Telephone | 832-434-7131
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618002100
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License Number State | VA
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