Provider Demographics
NPI:1487659561
Name:SMITH, BELINDA K (DO)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:K
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1464 JEFFERSON ST N
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:WV
Mailing Address - Zip Code:24901-1380
Mailing Address - Country:US
Mailing Address - Phone:304-645-3220
Mailing Address - Fax:304-645-4103
Practice Address - Street 1:1464 JEFFERSON ST N
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:WV
Practice Address - Zip Code:24901-1380
Practice Address - Country:US
Practice Address - Phone:304-645-3220
Practice Address - Fax:304-645-4103
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2016-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV968207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV54183971800OtherWV WORKERS COMPENSATION
74387OtherSOUTHERN HEALTH
200026OtherLUNG
262075OtherANTHEM
0441939OtherCIGNA
4484772OtherAETNA
541839718OtherC&O
WV541839718032OtherBS MOUNTAIN STATE
WV0051282000Medicaid
5189281OtherCCN
74387OtherCARELINK
WV54183971800OtherWV WORKERS COMPENSATION
74387OtherSOUTHERN HEALTH
541839718OtherC&O
1200890003Medicare ID - Type UnspecifiedADMINSTAR FEDERAL
WV0051282000Medicaid
080095166Medicare ID - Type UnspecifiedRAILROAD MEDICARE/RRMC