Organization
FAIRFAX RADIOLOGICAL CONSULTANTS PC
Active
Parent organization
FAIRFAX RADIOLOGICAL CONSULTANTS PC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRFAX RADIOLOGICAL CONSULTANTS PC
Authorized official
BILL F ALLISON (EXECUTIVE DIRECTOR)
(703) 698-4483
Entity
Organization
Contact information
Practice address
115 PARK ST SE, STE 203, VIENNA, VA 22180-4653
(703) 698-4483
(703) 573-0880
Mailing address
PO BOX 3650, MERRIFIELD, VA 22116-3650
(703) 698-4444
(703) 573-0880
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
—
—
261QR0200X
Radiology Clinic/Center
Primary
—
—
261QR0206X
Mammography Clinic/Center
221597
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100497
KAISER
VA
01
—
224404
ANTHEM BCBS
VA
01
—
9363
AETNA
VA
Enumeration date
01/10/2008
Last updated
01/12/2011
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