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Organization
FAIRFAX ENT & FACIAL PLASTIC SURGERY, PC
Active
Organization
FAIRFAX ENT & FACIAL PLASTIC SURGERY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAURENCE R O'HALLORAN MD (PRESIDENT)
(703) 573-3687
Entity
Organization
Contact information
Practice address
8120 GATEHOUSE RD, #3, FALLS CHURCH, VA 22042-1204
(703) 573-3687
(703) 204-0114
Mailing address
8120 GATEHOUSE RD, #3, FALLS CHURCH, VA 22042-1204
(703) 573-3687
(703) 204-0114
Taxonomy
Speciality
Code
Description
License number
State
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
0101051134
VA
Other
Enumeration date
03/14/2008
Last updated
06/15/2016
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