Organization
FAIRFAX EYE CENTER, PC
Active
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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