Provider Demographics
NPI:1518909670
Name:SMITH, JULIOUS PERRY III (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIOUS
Middle Name:PERRY
Last Name:SMITH
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:1115 BOULDERS PKWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4067
Mailing Address - Country:US
Mailing Address - Phone:804-560-5595
Mailing Address - Fax:804-560-9029
Practice Address - Street 1:5899 BREMO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1935
Practice Address - Country:US
Practice Address - Phone:804-288-8512
Practice Address - Fax:804-288-4552
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2020-09-16
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Provider Licenses
StateLicense IDTaxonomies
VA101055368207XX0005X
VA0101055368207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA200037874OtherRAILROAD MEDICARE
VA2320408OtherAETNA HMO
VA216268OtherANTHEM HEALTHKEEPERS
VA31621OtherOPTIMA HEALTH
VA540885859OtherCIGNA
VA006408206Medicaid
VA2138347OtherUNITED HEALTHCARE MAMSI
VA288989OtherSOUTHERN HEALTH
VA540885859OtherFOCUS
VA540885859OtherCORVEL
VA540885859OtherFIRST HEALTH/CCN
VA1518909670Medicaid
VA386541OtherANTHEM WEST END OPERATORY
VA540885859OtherPRIVATE HEALTHCARE SYSTEM
VA540885859OtherCOMPMANAGEMENT
VA19707OtherSH CARENET
VA0900887OtherUNITED HEALTHCARE
VA540885859OtherC&O EMPLOYEE'S HEALTHCARE
VA2320408OtherAETNA HMO
VA1518909670Medicaid
VA0472640017Medicare NSC
VA19707OtherSH CARENET