Provider Demographics
NPI:1366688160
Name:ARLINGTON LOUDOUN PEDIATRIC OPHTHALMOLOGY PLLC
Entity Type:Organization
Organization Name:ARLINGTON LOUDOUN PEDIATRIC OPHTHALMOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:KERN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-434-2927
Mailing Address - Street 1:46161 WESTLAKE DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20165-5871
Mailing Address - Country:US
Mailing Address - Phone:571-434-2927
Mailing Address - Fax:571-434-0838
Practice Address - Street 1:46161 WESTLAKE DR STE 300
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-5871
Practice Address - Country:US
Practice Address - Phone:571-434-2927
Practice Address - Fax:571-434-0838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty