Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | 0102201627 | VA |
NPI | 1023089299 |
---|---|
Provider Name | Dr. James Anthony Treadwell |
First Address | Danville, VA 24541-1222 |
Second Address | South Boston, VA 24592-5200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2006 |
Last Update Date | 05/02/2018 |