# FAIRFAX RADIOLOGICAL CONSULTANTS PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FAIRFAX RADIOLOGICAL CONSULTANTS PC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1417133398
- **Legal business name:** FAIRFAX RADIOLOGICAL CONSULTANTS PC
- **Authorized official:** BILL F ALLISON (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (703) 698-4483

## Contact information

- **Practice address:** 115 PARK ST SE, STE 203, VIENNA, VA 22180-4653
- **Practice address phone:** (703) 698-4483
- **Practice address fax:** (703) 573-0880
- **Mailing address:** PO BOX 3650, MERRIFIELD, VA 22116-3650
- **Mailing address phone:** (703) 698-4444
- **Mailing address fax:** (703) 573-0880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 174400000X | Specialist | — | NULL | — |
| 174400000X | Specialist | — | — | — |
| 261QR0200X | Radiology Clinic/Center | — | NULL | Yes |
| 261QR0206X | Mammography Clinic/Center | 221597 | VA | — |

## Other

- **Enumeration date:** 01/10/2008
- **Last updated:** 01/12/2011