Provider Demographics
NPI:1770667651
Name:SMALLFIELD, GEORGE B III (MD, MS)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:B
Last Name:SMALLFIELD
Suffix:III
Gender:M
Credentials:MD, MS
Other - Prefix:
Other - First Name:GEORGE
Other - Middle Name:BLAIR
Other - Last Name:SMALLFIELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:863 GLENROCK RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3701
Mailing Address - Country:US
Mailing Address - Phone:757-252-2900
Mailing Address - Fax:757-252-3235
Practice Address - Street 1:863 GLENROCK RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3701
Practice Address - Country:US
Practice Address - Phone:757-252-2900
Practice Address - Fax:757-252-3235
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101252208207R00000X, 207RG0100X
AL26542207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL111227Medicaid
AL110553Medicaid
MS01436765Medicaid
AL51598342OtherBCBS
AL51598343OtherBCBS
P00839378OtherRAILROAD MEDICARE
AL51598343OtherBCBS