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Organization

FAIRFAX SURGICAL CENTER, L.P.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WILLIAM GREGORY SWINNEY (VP)
(972) 789-2877
Entity
Organization

Contact information

Practice address
10730 MAIN ST, FAIRFAX, VA 22030-3704
(703) 691-0670
(703) 385-2865
Mailing address
10730 MAIN ST, FAIRFAX, VA 22030-3704
(703) 691-0670
(703) 385-2865

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
OH654
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7603827
VA
Enumeration date
04/07/2006
Last updated
02/15/2018
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