Provider Demographics
NPI:1326334293
Name:SMALLEY, JEREMY CURTIS (MD)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:CURTIS
Last Name:SMALLEY
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 1:101 KNOTBREAK RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-5404
Mailing Address - Country:US
Mailing Address - Phone:540-444-4020
Mailing Address - Fax:540-444-4021
Practice Address - Street 1:101 KNOTBREAK RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:VA
Practice Address - Zip Code:24153-5404
Practice Address - Country:US
Practice Address - Phone:540-444-4020
Practice Address - Fax:540-444-4021
Is Sole Proprietor?:No
Enumeration Date:2011-06-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0081653207X00000X
VA0101262872207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0081653OtherMARYLAND PHYSICIAN LICENSE