Theisz, Gordon W

Theisz, Gordon W is an individual health care provider with primary practice located at 124 E Broad St Ste A , Falls Church VA 22046-4530. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Theisz, Gordon W can be contacted via phone (703) 533-7555.

Contact Information

Primary practice address
124 E Broad St Ste A Falls Church VA 22046-4530
Phone: (703) 533-7555
Fax: (703) 533-7797
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 0101102617 Virginia

Profile Details

NPI number 1437101508
LBN Legal business name Theisz, Gordon W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Jan 19th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437101508 NPPES
Virginia MEDICAID 010189781
Virginia Other P00377886

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