Individual
KEITH SMITHSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
11656 PLAZA AMERICA DR, RESTON, VA 20190-4767
(703) 467-9080
(703) 467-9082
Mailing address
7263E ARLINGTON BLVD, FALLS CHURCH, VA 22042-3219
(703) 573-1200
(703) 573-1250
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618001041
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009232231
—
VA
01
—
2663321
AETNA HMO
VA
01
—
295571
MAMSI/ALLIANCE
VA
01
—
383934
ANTHEM BCBS/RESTON
VA
01
—
383935
ANTHEM BCBS/ALEXANDRIA
VA
01
—
7671300
AETNA PPO
VA
01
—
9314-0007
BCBS/CAREFIRST
VA
Enumeration date
08/03/2006
Last updated
07/08/2007
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