Provider Demographics
NPI:1942636295
Name:JOSEPH F. SMITH PSYCHIATRY, INC.
Entity Type:Organization
Organization Name:JOSEPH F. SMITH PSYCHIATRY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:F
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-772-8043
Mailing Address - Street 1:4346 STARKEY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-0605
Mailing Address - Country:US
Mailing Address - Phone:540-772-8043
Mailing Address - Fax:540-772-8242
Practice Address - Street 1:4346 STARKEY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0605
Practice Address - Country:US
Practice Address - Phone:540-772-8043
Practice Address - Fax:540-772-8242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043204103TP0016X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TP0016XBehavioral Health & Social Service ProvidersPsychologistPrescribing (Medical)Group - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1992744643Medicaid
VA1992744643Medicaid