Provider Demographics
NPI:1982194122
Name:SMITH-HARRISON, LEON ISMAEL II (MD)
Entity Type:Individual
Prefix:DR
First Name:LEON
Middle Name:ISMAEL
Last Name:SMITH-HARRISON
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 WESTMORELAND AVE
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-1320
Mailing Address - Country:US
Mailing Address - Phone:361-813-8131
Mailing Address - Fax:
Practice Address - Street 1:155 KINGSLEY LN STE 400
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23505-4629
Practice Address - Country:US
Practice Address - Phone:757-278-2240
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-14
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101279047207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine