Provider Demographics
NPI:1346942554
Name:YOUNG SMITH, ALLISON (PA)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:YOUNG SMITH
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
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Mailing Address - Street 1:220 CAMPUS BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-2889
Mailing Address - Country:US
Mailing Address - Phone:540-536-5100
Mailing Address - Fax:540-536-0235
Practice Address - Street 1:607 E JUBAL EARLY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5178
Practice Address - Country:US
Practice Address - Phone:540-536-2232
Practice Address - Fax:540-536-2206
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2024-01-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WV2712363A00000X
VA0110009201363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant