Provider Demographics
NPI:1205978111
Name:FREDERICKSBURG ORTHOPAEDIC ASSOC PC
Entity type:Organization
Organization Name:FREDERICKSBURG ORTHOPAEDIC ASSOC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:DEBLASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-373-4602
Mailing Address - Street 1:3310 FALL HILL AVENUE
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401
Mailing Address - Country:US
Mailing Address - Phone:540-373-4602
Mailing Address - Fax:540-371-3487
Practice Address - Street 1:3310 FALL HILL AVENUE
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401
Practice Address - Country:US
Practice Address - Phone:540-373-4602
Practice Address - Fax:540-371-3487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC07813Medicare ID - Type Unspecified