Provider Demographics
NPI:1447230750
Name:SMITH, JOHN H (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:H
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:885 KEMPSVILLE RD
Mailing Address - Street 2:SUITE 114
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3800
Mailing Address - Country:US
Mailing Address - Phone:757-466-0165
Mailing Address - Fax:757-466-7296
Practice Address - Street 1:885 KEMPSVILLE RD
Practice Address - Street 2:SUITE 114
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3800
Practice Address - Country:US
Practice Address - Phone:757-466-0165
Practice Address - Fax:757-466-7296
Is Sole Proprietor?:No
Enumeration Date:2006-01-20
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101058086207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010132690Medicaid
VA174068OtherANTHEM BCBS
VA2310188OtherCIGNA
VAP00210319OtherMEDICARE RAILROAD
VA7849751OtherAETNA
VA93384OtherOPTIMA HEALTH PLAN
VA7849751OtherAETNA
VAI26166Medicare UPIN