Healthcare Provider Details

I. General information

NPI: 1649167974
Provider Name (Legal Business Name): PAIGE KERRIGAN SMITH OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2025
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 WESTWOOD MEDICAL PARK
BLUEFIELD VA
24605
US

IV. Provider business mailing address

14 WESTWOOD MEDICAL PARK
BLUEFIELD VA
24605
US

V. Phone/Fax

Practice location:
  • Phone: 276-322-7335
  • Fax: 276-223-0327
Mailing address:
  • Phone: 276-322-7335
  • Fax: 276-223-0327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number0618003525
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: