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GORDON L HEAD MD

Body Imaging >> Radiology >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1912925926

Individual Registrant:
 GORDON L HEAD MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2722 MERRILEE DR SUITE 230 FAIRFAX, VA 22031-4400 US
Tel: 703-698-4483  Fax: 703-573-0880

Contact information for business:
PO BOX 3650  FAIRFAX, VA 22038-3650 US
Tel: 703-698-4483  Fax: 703-573-0880

Registration Information:
NPI: 1912925926
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N2085B0100XAllopathic & Osteopathic Physicians
Radiology
Body Imaging
VA0101030851
N2085N0700XAllopathic & Osteopathic Physicians
Radiology
VA0101030851
N2085N0904XAllopathic & Osteopathic Physicians
Radiology
VA0101030851
N2085P0229XAllopathic & Osteopathic Physicians
Radiology
VA0101030851
Y2085R0202XAllopathic & Osteopathic Physicians
Radiology
VA0101030851
N2085R0204XAllopathic & Osteopathic Physicians
Radiology
VA0101030851
N2085U0001XAllopathic & Osteopathic Physicians
Radiology
VA0101030851

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
CAREFIRST0012VA01




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