Organization
FAIRFAX EYE CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HEATHER DIANNE HARTZELL M.D. (PRESIDENT AND OWNER)
(508) 801-5833
Entity
Organization
Contact information
Practice address
3650 JOSEPH SIEWICK DR STE 303, FAIRFAX, VA 22033-1714
(508) 801-5833
(703) 242-0919
Mailing address
2916 HIBBARD ST, OAKTON, VA 22124-2648
(508) 801-5833
(703) 242-0919
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101239520
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
492195
MEDICARE PTAN
VA
Enumeration date
10/10/2007
Last updated
10/10/2007
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