Provider Demographics
NPI:1043389331
Name:ALEXANDRIA ASSOCIATES IN DERMATOLOGY, PC
Entity Type:Organization
Organization Name:ALEXANDRIA ASSOCIATES IN DERMATOLOGY, PC
Other - Org Name:ASSOCIATES IN DERMATOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:K
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-212-7546
Mailing Address - Street 1:1900 N. BEAUREGARD STREET
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22311
Mailing Address - Country:US
Mailing Address - Phone:703-212-7546
Mailing Address - Fax:703-212-7282
Practice Address - Street 1:1900 N. BEAUREGARD STREET
Practice Address - Street 2:SUITE 110
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22311
Practice Address - Country:US
Practice Address - Phone:703-212-7546
Practice Address - Fax:703-212-7282
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-08
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
681531Medicare ID - Type Unspecified