# ABINGDON FAMILY PRACTICE PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033108857
- **Authorized official:** SIMON P PENNINGS (PRESIDENT)
- **Authorized official phone:** (276) 628-1186

## Contact information

- **Practice address:** 617 CAMPUS DR, ABINGDON, VA 24210-9700
- **Practice address phone:** (276) 628-1186
- **Practice address fax:** (276) 628-8507
- **Mailing address:** 617 CAMPUS DR, ABINGDON, VA 24210-9700
- **Mailing address phone:** (276) 628-1186
- **Mailing address fax:** (276) 628-8507

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/14/2005
- **Last updated:** 06/16/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005607531 | — | VA |
| 05 | — | 005641802 | — | VA |
| 05 | — | 005642507 | — | VA |
| 01 | — | 064411 | ANTHEM | — |
| 01 | — | 2102748 | MAMSI | — |
| 01 | — | 226900 | ANTHEM | — |
| 01 | — | 3054602 | BLUE CLASSIE | — |
| 01 | — | 460464 | ANTHEM | — |
| 01 | — | 5603067 | AETNA | — |
| 01 | — | 5752880001 | MEDICARE NCS | VA |
| 01 | — | 5756306 | AETNA | — |
| 01 | — | C03006 | MEDICARE PROVIDER | VA |