1003139122 NPI number — KATHLEEN BRELSFORD FRENCH, M.D., P.C.

Table of content: (NPI 1003139122)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003139122 NPI number — KATHLEEN BRELSFORD FRENCH, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KATHLEEN BRELSFORD FRENCH, M.D., P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1003139122
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3020 HAMAKER CT
Provider Second Line Business Mailing Address:
SUITE B104
Provider Business Mailing Address City Name:
FAIRFAX
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22031-2238
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-641-4877
Provider Business Mailing Address Fax Number:
703-641-1123

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3020 HAMAKER CT
Provider Second Line Business Practice Location Address:
SUITE B104
Provider Business Practice Location Address City Name:
FAIRFAX
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22031-2238
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-641-4877
Provider Business Practice Location Address Fax Number:
703-641-1123
Provider Enumeration Date:
03/03/2010

Additional Information

Authorized Official

Authorized Official Last Name:
FRENCH
Authorized Official First Name:
KATHLEEN
Authorized Official Middle Name:
BRELSFORD
Authorized Official Title or Position:
OWNER/NEUROSURGEON
Authorized Official Telephone Number:
703-641-4877

Provider Taxonomy Codes

  • Taxonomy code: 207T00000X , with the licence number:  0101042074 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0600023 . This is a "UNITEDHEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 077829 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 615298 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30888 . This is a "MAMSI/OPT CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0488417 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7147 . This is a "CAREFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30888 . This is a "ALLIANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 07147 . This is a "BLUECHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 077829 . This is a "HEALTHKEEPERS" identifier . This identifiers is of the category "OTHER".




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