=====================================================
General NPI Number Information
=====================================================
NPI Number | 1063491132
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ABINGDON PHYSICIAN PARTNERS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/17/2006
-----------------------------------------------------
Last Update Date | 11/07/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 108 ABINGDON PL
-----------------------------------------------------
City | ABINGDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24211-5197
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-623-8133
-----------------------------------------------------
Fax | 276-623-2471
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 351 COURT ST
-----------------------------------------------------
City | ABINGDON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 24210-2921
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 276-623-8133
-----------------------------------------------------
Fax | 276-623-2471
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN
-----------------------------------------------------
Name | RACHEL HAYS
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 276-623-8133
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------