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General NPI Number Information
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NPI Number | 1548297070
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Entity Type | Organization
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Legal Business Name | ABINGDON EYE ASSOCIATES, P.C.
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Dates
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Enumeration Date | 06/28/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 418 E MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-3408
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Country | US
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Telephone | 276-628-9141
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Fax | 276-628-4441
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Provider Business Mailing Address
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Address Line | 418 E MAIN ST
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City | ABINGDON
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State | VA
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Zip | 24210-3408
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Country | US
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Telephone | 276-628-9141
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Fax | 276-628-4441
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Authorized Official
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Title or Position | OWNER
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Name | FREDERICK ELLISON CONRAD
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Credential | M.D.
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Telephone | 276-628-9141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 0101021147
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 0101021147
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License Number State | VA
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