Smith, Thomas Larry

Smith, Thomas Larry is an individual health care provider with primary practice located at 2200 Opitz Blvd Suite 100, Woodbridge VA 22191-3321. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Smith, Thomas Larry can be contacted via phone (703) 492-4140.

Contact Information

Primary practice address
2200 Opitz Blvd Suite 100 Woodbridge VA 22191-3321
Phone: (703) 492-4140
Fax: (703) 991-8104
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0101052153 Virginia
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 101052153 Virginia

Profile Details

NPI number 1184685976
LBN Legal business name Smith, Thomas Larry
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Feb 6th, 2015 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184685976 NPPES
Virginia MEDICAID 5900409

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