Provider Demographics
NPI:1508940180
Name:FAMILY MEDICAL CARE OF SMITHFIELD PLC
Entity Type:Organization
Organization Name:FAMILY MEDICAL CARE OF SMITHFIELD PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:C
Authorized Official - Last Name:POPE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-357-3331
Mailing Address - Street 1:201 GUMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23430-6086
Mailing Address - Country:US
Mailing Address - Phone:757-357-3331
Mailing Address - Fax:757-357-6635
Practice Address - Street 1:201 GUMWOOD DR
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:VA
Practice Address - Zip Code:23430-6086
Practice Address - Country:US
Practice Address - Phone:757-357-3331
Practice Address - Fax:757-357-6635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101232510207R00000X, 208000000X
VA0101232509207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010123755Medicaid
VA175006OtherBCBS DR. SHANNON POPE
VA010132487Medicaid
VA175031OtherBCBS DR. TOM POPE
VAH52785Medicare UPIN
VAOOW346F01Medicare ID - Type UnspecifiedDR. SHANNON POPE'S MEDIC
VA010132487Medicaid
VAH67506Medicare UPIN