Organization
FAIRFAX FAMILY PRACTICE CENTERS, P.C.
Active
Parent organization
FAIRFAX FAMILY PRACTICE CENTERS, PC
Other names
Family Medicine of Clifton-Centreville
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAIRFAX FAMILY PRACTICE CENTERS, PC
Authorized official
DR. JAMES P. JENKINS JR. MD (PRESIDENT)
(703) 391-2030
Entity
Organization
Contact information
Practice address
6201 CENTREVILLE RD STE 100, CENTREVILLE, VA 20121-2626
(703) 263-9600
(703) 266-1452
Mailing address
PO BOX 791128, BALTIMORE, MD 21279-1128
(703) 391-2030
(703) 273-3943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
0631926
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010072409
—
VA
01
—
1063418762
NPI
VA
01
—
11664428801
NPI
VA
01
—
1205944964
NPI
VA
01
—
1245236926
NPI
VA
01
—
1487657136
NPI
VA
01
—
1548266117
NPI
VA
01
—
1699771394
NPI
VA
01
—
1790781474
NPI
VA
05
—
5604761
—
VA
05
—
5618916
—
VA
05
—
5618959
—
VA
05
—
5619050
—
VA
05
—
5619076
—
VA
05
—
5619181
—
VA
01
—
CO8267
VIRGINIA MEDICARE
VA
01
—
G00522
MEDICARE HIGHMARK
VA
Enumeration date
10/24/2006
Last updated
02/21/2014
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