| Fairfax Family Practice | |
|
3650 Joseph Siewick Drive Suite 400 Fairfax VA 22033 | |
| (703) 391-2020 | |
| (703) 391-1211 |
| Full Name | Fairfax Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 3650 Joseph Siewick Drive, Fairfax, Virginia |
| Authorized Official Name and Position | James P Jenkins (PRESIDENT) |
| Authorized Official Contact | 7032559100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairfax Family Practice Po Box 791128 Baltimore MD 21279-1128 Ph: (703) 391-2020 | Fairfax Family Practice 3650 Joseph Siewick Drive Suite 400 Fairfax VA 22033 Ph: (703) 391-2020 |
| NPI Number | 1639296254 |
|---|---|
| Provider Enumeration Date | 03/26/2007 |
| Last Update Date | 12/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639296254 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (NU) | Primary |
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