Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 0102204264 | VA |
N | 207Q00000X | Family Doctor | 0102204264 | VA |
N | 207QA0401X | Family Doctor - Addiction Medicine | 0102204264 | VA |
N | 207QA0505X | Family Doctor - Adult Medicine | 0102204264 | VA |
N | 207RA0401X | Internist - Addiction Medicine | 0102204264 | VA |
N | 208D00000X | General Practice Physician | 0102204264 | VA |
NPI | 1659639631 |
---|---|
Provider Name | Dr. Joel Adams Smithers |
First Address | Martinsville, VA 24112-2086 |
Second Address | Martinsville, VA 24112-2086 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2012 |
Last Update Date | 14/10/2015 |