| Broadlands Family Practice | |
|
20905 Professional Plaza Suite 330 Ashburn VA 20147 | |
| (703) 726-0003 | |
| (703) 726-6444 |
| Full Name | Broadlands Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 20905 Professional Plaza, Ashburn, Virginia |
| Authorized Official Name and Position | James P Jenkins (PRESIDENT) |
| Authorized Official Contact | 7032559100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Broadlands Family Practice Po Box 791128 Baltimore MD 21279-1128 Ph: (703) 726-0003 | Broadlands Family Practice 20905 Professional Plaza Suite 330 Ashburn VA 20147 Ph: (703) 726-0003 |
| NPI Number | 1184748360 |
|---|---|
| Provider Enumeration Date | 03/16/2007 |
| Last Update Date | 12/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184748360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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