Organization
FAIRFAX FAMILY PRACTICE CENTERS PC
Active
Parent organization
FAIRFAX FAMILY PRACTICE CENTERS PC
Other names
Broadlands Family Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRFAX FAMILY PRACTICE CENTERS PC
Authorized official
JAMES P JENKINS MD (PRESIDENT)
(703) 255-9100
Entity
Organization
Contact information
Practice address
20905 PROFESSIONAL PLAZA, SUITE 330, ASHBURN, VA 20147
(703) 726-0003
(703) 726-6444
Mailing address
PO BOX 791128, BALTIMORE, MD 21279-1128
(703) 726-0003
(703) 726-6444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
03/16/2007
Last updated
12/27/2007
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