Provider Demographics
NPI:1790833234
Name:STEINER, PHILLIP KIRK (OD)
Entity Type:Individual
Prefix:DR
First Name:PHILLIP
Middle Name:KIRK
Last Name:STEINER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7712 KILLEBREW DR
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-5119
Mailing Address - Country:US
Mailing Address - Phone:703-642-2239
Mailing Address - Fax:
Practice Address - Street 1:6201 LEESBURG PIKE STE 7
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2201
Practice Address - Country:US
Practice Address - Phone:703-237-1770
Practice Address - Fax:703-237-1773
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2008-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000133152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA024963Medicare ID - Type Unspecified