Provider Demographics
NPI:1578643326
Name:SEVEN CORNERS FAMILY PRACTICE
Entity type:Organization
Organization Name:SEVEN CORNERS FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:HENSLEE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:703-241-8768
Mailing Address - Street 1:6400 SEVEN CORNERS PL
Mailing Address - Street 2:SUITE M
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22044-2032
Mailing Address - Country:US
Mailing Address - Phone:703-241-8768
Mailing Address - Fax:703-536-6200
Practice Address - Street 1:6400 SEVEN CORNERS PL
Practice Address - Street 2:SUITE M
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22044-2032
Practice Address - Country:US
Practice Address - Phone:703-241-8768
Practice Address - Fax:703-536-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101230929261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care