Individual
KIRBY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
15564 WESTCHESTER COMMONS WAY, MIDLOTHIAN, VA 23113-7321
(804) 440-4878
Mailing address
15564 WC COMMONS WAY, MIDLOTHIAN, VA 23113-7321
(804) 440-4878
(804) 497-1136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006023
VA
363AS0400X
Surgical Physician Assistant
0110006023
VA
Other
Enumeration date
01/17/2018
Last updated
06/30/2023
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