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General NPI Number Information
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NPI Number | 1134538184
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Entity Type | Individual
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Provider Name | HERBERT JOHN SMITH D.V.M.
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Gender | Male
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Dates
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Enumeration Date | 08/04/2014
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 934 BLACKWELLS WHARF RD
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City | BURGESS
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State | VA
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Zip | 22432-2112
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Country | US
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Telephone | 804-453-5519
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Fax | 804-453-5519
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Provider Business Mailing Address
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Address Line | 934 BLACKWELLS WHARF RD
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City | BURGESS
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State | VA
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Zip | 22432-2112
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Country | US
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Telephone | 804-453-5519
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Fax | 804-453-5519
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 0301001614
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License Number State | VA
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