1649251521 NPI number — JAMES WAYNE DENTON M.D.

Employer Identification Number (EIN)	:
Provider Organization Name (Legal Business Name)	:
Provider Last Name (Legal Name)	:	DENTON
Provider First Name	:	JAMES
Provider Middle Name	:	WAYNE
Provider Name Prefix Text	:
Provider Name Suffix Text	:
Provider Credential Text	:	M.D.
Provider Gender Code	:	M

Provider Other Organization Name	:
Provider Other Organization Name Type Code	:
Provider Other Last Name	:
Provider Other First Name	:
Provider Other Middle Name	:
Provider Other Name Prefix Text	:
Provider Other Name Suffix Text	:
Provider Other Credential Text	:
Provider Other Last Name Type Code	:

NPI Number	:	1649251521
Entity Type Code	:	Individual
Replacement NPI	:
Last Update Date	:	11/20/2007
NPI Deactivation Reason Code	:
NPI Deactivation Date	:
NPI Reactivation Date	:

Provider First Line Business Mailing Address	:	275 WHITE ST NE
Provider Second Line Business Mailing Address	:
Provider Business Mailing Address City Name	:	ABINGDON
Provider Business Mailing Address State Name	:	VA
Provider Business Mailing Address Postal Code	:	242102913
Provider Business Mailing Address Country Code	:	US
Provider Business Mailing Address Telephone Number	:	2766289294
Provider Business Mailing Address Fax Number	:	2766231000

Provider First Line Business Practice Location Address	:	275 WHITE ST NE
Provider Second Line Business Practice Location Address	:
Provider Business Practice Location Address City Name	:	ABINGDON
Provider Business Practice Location Address State Name	:	VA
Provider Business Practice Location Address Postal Code	:	242102913
Provider Business Practice Location Address Country Code	:	US
Provider Business Practice Location Address Telephone Number	:	2766289294
Provider Business Practice Location Address Fax Number	:	2766231000
Provider Enumeration Date	:	11/08/2005

Authorized Official Last Name	:
Authorized Official First Name	:
Authorized Official Middle Name	:
Authorized Official Title or Position	:
Authorized Official Telephone Number	:

• Taxonomy code: 208600000X , with the licence number:  0101039289 , registered in the state of VA .

• Identifier: 1455522 . This is a "UMWA" identifier . This identifiers is of the category "".
• Identifier: 268560 . This is a "ANTHEM" identifier . This identifiers is of the category "".
• Identifier: C09949 . This is a "MEDICARE GROUP" identifier . This identifiers is of the category "".
• Identifier: 013046A49 . This identifiers is of the category "".
• Identifier: 084235 . This is a "ANTHEM" identifier , issued by the state of ( VA ) . This identifiers is of the category "".
• Identifier: B09345 . This identifiers is of the category "".
• Identifier: 1306944350 . This is a "GROUP NPI" identifier . This identifiers is of the category "".