Healthcare Provider Details

I. General information

NPI: 1346942554
Provider Name (Legal Business Name): ALLISON YOUNG SMITH PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2023
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

607 E JUBAL EARLY DR
WINCHESTER VA
22601-5178
US

IV. Provider business mailing address

220 CAMPUS BLVD STE 210
WINCHESTER VA
22601-2889
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-2232
  • Fax: 540-536-2206
Mailing address:
  • Phone: 540-536-5100
  • Fax: 540-536-0235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2712
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110009201
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: