MEDICARE: ABINGDON EYE ASSOCIATES, P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	0101021147	VA
2	208200000X	Plastic Surgery Physician	0101021147	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	078701	OTHER	VA	ANTHEM
2	016335	OTHER	VA	OUT OF STATE BC CLAIMS

General Provider Information

NPI Number	:	1548297070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABINGDON EYE ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	418 E MAIN ST
Second Line	:
City	:	ABINGDON
State	:	VA
Zip	:	24210-3408
Country	:	US
Telephone Number	:	276-628-9141
Fax Number	:	276-628-4441

Provider Business Practice Location Address
First Line	:	418 E MAIN ST
Second Line	:
City	:	ABINGDON
State	:	VA
Zip	:	24210-3408
Country	:	US
Telephone Number	:	276-628-9141
Fax Number	:	276-628-4441

Authorized Official
Title or Position	:	OWNER
Name	:	FREDERICK ELLISON CONRAD
Credential	:	M.D.
Telephone Number	:	276-628-9141

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	09/11/2025

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