Fairfax Urology Associates LTD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

0101022555 Issued in VA

Legal business name

FAIRFAX UROLOGY ASSOCIATES LTD

Practice address

10875 Main St
Suite 208
Fairfax, VA 22030-4732

Phone

(703) 591-5443

Fax

(703) 591-0486

NPI assigned

Sep 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. William Lloyd Glover Jr., MD

Title

Ceo Owner

Phone

(703) 591-5443

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213056000000",
    "number": "1073700845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10875 MAIN ST",
            "address_2": "SUITE 208",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304732",
            "telephone_number": "703-591-5443",
            "fax_number": "703-591-0486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10875 MAIN ST",
            "address_2": "SUITE 208",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220304732",
            "telephone_number": "703-591-5443",
            "fax_number": "703-591-0486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRFAX UROLOGY ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-26",
        "last_updated": "2008-06-10",
        "status": "A",
        "authorized_official_last_name": "GLOVER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "CEO OWNER",
        "authorized_official_telephone_number": "703-591-5443",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "VA",
            "license": "0101022555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "010877",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR",
            "identifier": "340013417",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "6488",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ghazal Falahatpour, LPC

• Urology Physician in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Urology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.