Healthcare Provider Details

I. General information

NPI: 1184673725
Provider Name (Legal Business Name): SMITHFIELD MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 S CHURCH ST
SMITHFIELD VA
23430-1715
US

IV. Provider business mailing address

919 S CHURCH ST
SMITHFIELD VA
23430-1715
US

V. Phone/Fax

Practice location:
  • Phone: 757-356-9137
  • Fax:
Mailing address:
  • Phone: 757-356-9137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: VIRGINIA SMITH
Title or Position: PRACTICE MANAGER
Credential:
Phone: 757-365-8008