Provider Demographics
NPI:1902868458
Name:FAUQUIER HEARING SERVICES PLLC
Entity Type:Organization
Organization Name:FAUQUIER HEARING SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:MARKVA
Authorized Official - Suffix:
Authorized Official - Credentials:AUD
Authorized Official - Phone:540-341-7112
Mailing Address - Street 1:493 BLACKWELL ROAD
Mailing Address - Street 2:STE 311
Mailing Address - City:WARRENTON
Mailing Address - State:VA
Mailing Address - Zip Code:20186
Mailing Address - Country:US
Mailing Address - Phone:540-341-7112
Mailing Address - Fax:540-341-8361
Practice Address - Street 1:493 BLACKWELL ROAD
Practice Address - Street 2:STE 311
Practice Address - City:WARRENTON
Practice Address - State:VA
Practice Address - Zip Code:20186
Practice Address - Country:US
Practice Address - Phone:540-341-7112
Practice Address - Fax:540-341-8361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2101000621237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS83230Medicare UPIN