Healthcare Provider Details

I. General information

NPI: 1871714774
Provider Name (Legal Business Name): DONALD C. SMITH MD MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 07/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 FRANCIS MARION LANE
MARION VA
24354
US

IV. Provider business mailing address

201 FRANCIS MARION LANE
MARION VA
24354
US

V. Phone/Fax

Practice location:
  • Phone: 276-781-7450
  • Fax: 276-781-7455
Mailing address:
  • Phone: 276-781-7450
  • Fax: 276-781-7455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number0101027894
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: