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NPI Code Detail

MEDICARE: BRIDGET MARIE SMITH DO

MEDICARE: BRIDGET MARIE SMITH DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianOT022503PA
2207Q00000XFamily Medicine Physician0102210140VA

General Provider Information

NPI Number : 1114601143
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIDGET MARIE SMITH DO
Provider Business Mailing Address
First Line : 1340 CENTRAL PARK BLVD STE 100
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22401-4940
Country : US
Telephone Number : 540-741-4254
Fax Number :
Provider Business Practice Location Address
First Line : 12101 CAROL LN STE 101
Second Line :
City : FREDERICKSBURG
State : VA
Zip : 22407-6104
Country : US
Telephone Number : 540-741-9300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/12/2023
Last Update Date : 06/08/2026

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