Provider Demographics
NPI:1346526514
Name:HAN TON-THAT, M.D., P.C.
Entity Type:Organization
Organization Name:HAN TON-THAT, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HAN
Authorized Official - Middle Name:
Authorized Official - Last Name:TON-THAT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-534-9090
Mailing Address - Street 1:6305 CASTLE PL
Mailing Address - Street 2:SUITE 1-A
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-1905
Mailing Address - Country:US
Mailing Address - Phone:703-534-9090
Mailing Address - Fax:703-534-9191
Practice Address - Street 1:6305 CASTLE PL
Practice Address - Street 2:SUITE 1-A
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-1905
Practice Address - Country:US
Practice Address - Phone:703-534-9090
Practice Address - Fax:703-534-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101055233261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC031861600Medicaid
VA005838380Medicaid
MD177300300Medicaid
DC031861600Medicaid
643349Medicare PIN