| Health Connect Ipa | |
|
12011 Lee Jackson Memorial Hwy Suite 504 Fairfax VA 22033-3310 | |
| (703) 391-2042 | |
| (703) 273-3943 |
| Full Name | Health Connect Ipa |
|---|---|
| Speciality | Family Medicine |
| Location | 12011 Lee Jackson Memorial Hwy, Fairfax, Virginia |
| Authorized Official Name and Position | Lauri Rustand (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7033912042 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Connect Ipa 12011 Lee Jackson Memorial Hwy Suite 504 Fairfax VA 22033-3310 Ph: (703) 391-2042 | Health Connect Ipa 12011 Lee Jackson Memorial Hwy Suite 504 Fairfax VA 22033-3310 Ph: (703) 391-2042 |
| NPI Number | 1932447463 |
|---|---|
| Provider Enumeration Date | 01/17/2013 |
| Last Update Date | 07/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932447463 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Secondary |
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Health Connect Aco, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12011 Lee Jackson Hwy, Suite 504, Fairfax, VA 22033 Phone: 703-391-2042 | |
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Paramount Care Physicians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 12011 Lee Jackson Memorial Hwy, Suite 230, Fairfax, VA 22033 Phone: 703-222-0002 Fax: 703-449-9890 | |
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