Provider Demographics
NPI:1174641500
Name:SPRAGUE, JAMES B (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:B
Last Name:SPRAGUE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1515 CHAIN BRIDGE RD
Mailing Address - Street 2:SUITE G20
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101
Mailing Address - Country:US
Mailing Address - Phone:703-356-2141
Mailing Address - Fax:703-356-1492
Practice Address - Street 1:1515 CHAIN BRIDGE RD
Practice Address - Street 2:SUITE G20
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:703-356-2141
Practice Address - Fax:703-356-1492
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101036729207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G01018Medicare ID - Type Unspecified
C61693Medicare UPIN