MEDICARE: DR. JAMES R ABBOTT M.D.

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	207Q00000X	Family Medicine Physician		NC

General Provider Information

NPI Number	:	1699776880
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES R ABBOTT M.D.

Provider Business Mailing Address
First Line	:	5201 LEESBURG PIKE
Second Line	:	SUITE 1511
City	:	FALLS CHURCH
State	:	VA
Zip	:	22041-3203
Country	:	US
Telephone Number	:	703-681-6078
Fax Number	:

Provider Business Practice Location Address
First Line	:	238 BROOKLEY AVE
Second Line	:
City	:	BOLLING AFB
State	:	DC
Zip	:	20332-0001
Country	:	US
Telephone Number	:	202-404-5512
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2005
Last Update Date	:	07/08/2007

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