Provider Demographics
NPI:1689731234
Name:DRS FARR WAMPLER HENSON & WILLIAMS
Entity Type:Organization
Organization Name:DRS FARR WAMPLER HENSON & WILLIAMS
Other - Org Name:DRS WHITE FARR WAMPLER & HENSON LTD
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:G
Authorized Official - Last Name:FARR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-368-9234
Mailing Address - Street 1:8650 SUDLEY ROAD
Mailing Address - Street 2:#206
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110
Mailing Address - Country:US
Mailing Address - Phone:703-368-9234
Mailing Address - Fax:703-368-0505
Practice Address - Street 1:8650 SUDLEY ROAD
Practice Address - Street 2:#206
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110
Practice Address - Country:US
Practice Address - Phone:703-368-9234
Practice Address - Fax:703-368-0505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101049560208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA210992OtherBC BS
VA210992OtherBC BS