| Wynn Family Medicine, Pllc | |
|
8316 Arlington Blvd Suite 234 Fairfax VA 22031-5207 | |
| (703) 560-0300 | |
| (703) 560-8679 |
| Full Name | Wynn Family Medicine, Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8316 Arlington Blvd, Fairfax, Virginia |
| Authorized Official Name and Position | Alancia Christine Wynn (MANAGING OFFICER/OWNER) |
| Authorized Official Contact | 7035600300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wynn Family Medicine, Pllc 8316 Arlington Blvd Suite 234 Fairfax VA 22031-5207 Ph: (703) 560-0300 | Wynn Family Medicine, Pllc 8316 Arlington Blvd Suite 234 Fairfax VA 22031-5207 Ph: (703) 560-0300 |
| NPI Number | 1144497082 |
|---|---|
| Provider Enumeration Date | 05/09/2008 |
| Last Update Date | 11/01/2008 |
| Medicare PECOS PAC ID | 3577630524 |
|---|---|
| Medicare Enrollment ID | O20080917000606 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144497082 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 0101054642 (Virginia) | Primary |
| Provider Name | Alancia C Wynn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952373409 PECOS PAC ID: 2961579917 Enrollment ID: I20080917000580 |
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