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GORDON L HEAD MD
Body Imaging >> Radiology >> Allopathic & Osteopathic PhysiciansRegistrant NPI Number: 1912925926
Individual Registrant: GORDON L HEAD MD
Gender: M
Not Sole Proprietor
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
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
Tel: 703-698-4483 Fax: 703-573-0880
Registration Information:
NPI: 1912925926
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 2085B0100X | Allopathic & Osteopathic Physicians Radiology Body Imaging | VA | 0101030851 |
| N | 2085N0700X | Allopathic & Osteopathic Physicians Radiology | VA | 0101030851 |
| N | 2085N0904X | Allopathic & Osteopathic Physicians Radiology | VA | 0101030851 |
| N | 2085P0229X | Allopathic & Osteopathic Physicians Radiology | VA | 0101030851 |
| Y | 2085R0202X | Allopathic & Osteopathic Physicians Radiology | VA | 0101030851 |
| N | 2085R0204X | Allopathic & Osteopathic Physicians Radiology | VA | 0101030851 |
| N | 2085U0001X | Allopathic & Osteopathic Physicians Radiology | VA | 0101030851 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| CAREFIRST | 0012 | VA | 01 |
