Individual
KENNETH ANDREW SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-2339
Mailing address
1550 TOMCAT BLVD, VIRGINIA BEACH, VA 23460-2218
(757) 953-3933
(757) 953-3810
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
0102206341
VA
Other
Enumeration date
03/19/2019
Last updated
06/08/2023
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