Individual
JOSEPH F SMIDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
208 FRONT ST W, COEBURN, VA 24230
(276) 455-5556
(276) 455-5557
Mailing address
PO BOX 90, COEBURN, VA 24230-0090
(276) 455-5556
(423) 247-5254
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
0101018713
VA
207RP1001X
Pulmonary Disease Physician
Primary
33413
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006014267
VIRGINIA MEDICAID
VA
01
—
055803
ANTHEM
VA
01
—
100023154
PHP TENN CARE
TN
01
—
1738991
UNITED HEALTHCARE
TN
01
—
2005685
BLUE CROSS BLUE SHIELD
TN
05
—
3153299
—
TN
01
—
5983040
AETNA
TN
01
—
62134825602
JOHN DEERE HEALTHCARE
TN
01
—
64740723
KENTUCKY MEDICAID
KY
01
—
C05950
TRAILBLAZER GROUP PTAN
VA
Enumeration date
05/16/2006
Last updated
07/24/2019
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