Doretha Jones Smith

Individual provider Active NPI Driver · Kenbridge, VA

NPI 1003501701 · NPPES record last updated Apr 7, 2023

Key facts

NPI
1003501701
Entity type
Individual (NPI type 1)
Primary specialty
Driver 172A00000X
License
T69510507 (VA)
Practice address
10291 Plank Rd
Kenbridge, VA 23944-4011
Phone
(434) 312-1484
NPI assigned
Apr 7, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
T69510507VAMDDriver

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Driver 172A00000X T69510507 VA Yes

Addresses

Primary practice location

10291 Plank Rd
Kenbridge, VA 23944-4011

Mailing address

10291 Plank Rd
Kenbridge, VA 23944-4011
Phone (434) 312-1484

Other providers in Kenbridge, VA

All providers in Kenbridge, VA · Driver in Virginia

Sources for this page

Verify at the official NPI Registry.