Provider Demographics
NPI:1386685519
Name:SMITH, JAMES R (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 2485
Mailing Address - Street 2:
Mailing Address - City:CHRISTIANSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24068-2485
Mailing Address - Country:US
Mailing Address - Phone:540-382-4221
Mailing Address - Fax:540-552-3100
Practice Address - Street 1:225 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:CHRISTIANSBURG
Practice Address - State:VA
Practice Address - Zip Code:24073
Practice Address - Country:US
Practice Address - Phone:540-382-4221
Practice Address - Fax:540-381-1889
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058436207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB06265Medicare UPIN