Provider Demographics
NPI:1073761417
Name:SMITH, GEORGE LANDON (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:LANDON
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 1:5115 BERNARD DR STE 201
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-4367
Mailing Address - Country:US
Mailing Address - Phone:540-392-6281
Mailing Address - Fax:
Practice Address - Street 1:5115 BERNARD DR STE 201
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-4367
Practice Address - Country:US
Practice Address - Phone:540-345-0289
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101253298207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology