Healthcare Provider Details

I. General information

NPI: 1205191350
Provider Name (Legal Business Name): SMITA S AKKINAPALLY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/05/2012
Last Update Date: 02/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 COEBURN AVE SW
NORTON VA
24273-2606
US

IV. Provider business mailing address

105 W STONE DR STE 6A
KINGSPORT TN
37660-3256
US

V. Phone/Fax

Practice location:
  • Phone: 276-679-0800
  • Fax: 276-679-0097
Mailing address:
  • Phone: 423-408-7220
  • Fax: 423-408-7405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberL2160187
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0101264516
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: