Wynn Family Medicine, Pllc | |
8316 Arlington Blvd Suite 234 Fairfax VA 22031-5207 | |
(703) 560-0300 | |
(703) 560-8679 |
Full Name | Wynn Family Medicine, Pllc |
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Speciality | Clinic/Center |
Location | 8316 Arlington Blvd, Fairfax, Virginia |
Authorized Official Name and Position | Alancia Christine Wynn (MANAGING OFFICER/OWNER) |
Authorized Official Contact | 7035600300 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wynn Family Medicine, Pllc 8316 Arlington Blvd Suite 234 Fairfax VA 22031-5207 Ph: (703) 560-0300 | Wynn Family Medicine, Pllc 8316 Arlington Blvd Suite 234 Fairfax VA 22031-5207 Ph: (703) 560-0300 |
NPI Number | 1144497082 |
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Provider Enumeration Date | 05/09/2008 |
Last Update Date | 11/01/2008 |
Medicare PECOS PAC ID | 3577630524 |
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Medicare Enrollment ID | O20080917000606 |
Identifier | Type | State | Issuer |
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1144497082 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QP2300X | Clinic/center - Primary Care | 0101054642 (Virginia) | Primary |
Provider Name | Alancia C Wynn |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1952373409 PECOS PAC ID: 2961579917 Enrollment ID: I20080917000580 |
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