Provider Demographics
NPI:1063484863
Name:SMITH, RICHARD FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:FRANCIS
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 1:159 EXECUTIVE DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24541-4160
Mailing Address - Country:US
Mailing Address - Phone:434-792-0830
Mailing Address - Fax:434-792-0468
Practice Address - Street 1:159 EXECUTIVE DR
Practice Address - Street 2:SUITE C
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24541-4160
Practice Address - Country:US
Practice Address - Phone:434-792-0830
Practice Address - Fax:434-792-0468
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2009-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245403207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89133JJMedicaid
VA1063484863OtherANTHEM BCBS
VA1063484863Medicaid
VA1063484863Medicaid