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General NPI Number Information
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NPI Number | 1710123534
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Entity Type | Organization
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Legal Business Name | LARRY F SMITH MD PC
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Dates
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Enumeration Date | 12/29/2008
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Last Update Date | 05/25/2011
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Provider Practice Location Address
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Address Line | 181 OLD COURTHOUSE ROAD
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City | APPOMATTOX
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State | VA
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Zip | 24522-0666
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Country | US
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Telephone | 434-352-3003
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Fax | 434-352-5005
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Provider Business Mailing Address
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Address Line | PO BOX 666
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City | APPOMATTOX
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State | VA
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Zip | 24522-0666
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Country | US
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Telephone | 434-352-3003
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Fax | 434-352-5005
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY FRANCIS SMITH
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Credential | M.D.
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Telephone | 434-352-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101028468
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License Number State | VA
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