Provider Demographics
NPI:1033190905
Name:SMITH, DAVID HUNT (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:HUNT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16000 JOHNSTON MEMORIAL DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-7664
Mailing Address - Country:US
Mailing Address - Phone:276-258-1777
Mailing Address - Fax:276-258-1778
Practice Address - Street 1:16000 JOHNSTON MEMORIAL DR
Practice Address - Street 2:SUITE 101
Practice Address - City:ABINGDON
Practice Address - State:VA
Practice Address - Zip Code:24211-7664
Practice Address - Country:US
Practice Address - Phone:276-258-1777
Practice Address - Fax:276-258-1778
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101040859208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1033190905Medicaid
1419365OtherUMWA
VAP01615839OtherRAILROAD MEDICARE
1419365OtherUMWA
VA1033190905Medicaid
VA013047A49Medicare PIN