Organization
PRESTON SQUARE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CLARA JANE TOOTHMAN MD (PARTNER)
(276) 628-8303
Entity
Organization
Contact information
Practice address
24294 TEAL DRIVE, ABINGDON, VA 24211-6160
(276) 628-8303
(276) 466-4815
Mailing address
24294 TEAL DRIVE, ABINGDON, VA 24211-6160
(276) 628-8303
(276) 466-4815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD3927
RR MEDICARE
—
Enumeration date
07/15/2006
Last updated
12/16/2011
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