Provider Demographics
NPI:1720784507
Name:SMYTH COUNTY FAMILY PHYSICIANS
Entity Type:Organization
Organization Name:SMYTH COUNTY FAMILY PHYSICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHELSEA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-783-8123
Mailing Address - Street 1:1616 N MAIN ST STE C
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4474
Mailing Address - Country:US
Mailing Address - Phone:276-783-8123
Mailing Address - Fax:
Practice Address - Street 1:1616 N MAIN ST STE C
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4474
Practice Address - Country:US
Practice Address - Phone:276-783-8123
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-03
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30017588950001Medicaid