=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700834876
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FAUQUIER FAMILY PRACTICE P.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2006
-----------------------------------------------------
Last Update Date | 01/15/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400A HOSPITAL DR
-----------------------------------------------------
City | WARRENTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20186-3026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-341-4850
-----------------------------------------------------
Fax | 540-341-4851
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400A HOSPITAL DR
-----------------------------------------------------
City | WARRENTON
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 20186-3026
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-341-4850
-----------------------------------------------------
Fax | 540-341-4851
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | DR. MICHAEL T LIN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 540-341-4850
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------