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General NPI Number Information
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NPI Number | 1114129574
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Entity Type | Organization
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Legal Business Name | HEMATOLOGY ONCOLOGY ASSOC LTD
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Dates
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Enumeration Date | 06/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5226 DAWES AVENUE
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City | ALEXANDRIA
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State | VA
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Zip | 22311
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Country | US
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Telephone | 703-379-9111
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Fax | 703-931-7952
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Provider Business Mailing Address
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Address Line | 5226 DAWES AVENUE
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City | ALEXANDRIA
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State | VA
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Zip | 22311
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Country | US
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Telephone | 703-379-9111
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Fax | 703-931-7952
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Authorized Official
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Title or Position | PRESIDENT
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Name | LEROY F SMITH JR.
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Credential | MD
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Telephone | 703-379-9111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0101018898
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License Number State | VA
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