Provider Demographics
NPI:1487755955
Name:TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C.
Entity type:Organization
Organization Name:TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NARWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOBAR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:703-483-4647
Mailing Address - Street 1:1860 TOWN CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20190-5896
Mailing Address - Country:US
Mailing Address - Phone:703-435-6604
Mailing Address - Fax:703-787-6575
Practice Address - Street 1:1860 TOWN CENTER DR
Practice Address - Street 2:SUITE 300
Practice Address - City:RESTON
Practice Address - State:VA
Practice Address - Zip Code:20190-5900
Practice Address - Country:US
Practice Address - Phone:703-435-6604
Practice Address - Fax:703-787-6575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-26
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
207XS0106X, 208100000X, 207XX0005X, 225100000X, 225X00000X, 207XS0117X
VA207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Multi-Specialty
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0823200001Medicare NSC
813399Medicare PIN