Amanda Elizabeth Smart, | |
19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176-8470 | |
(703) 724-1195 | |
(703) 724-4495 |
Full Name | Amanda Elizabeth Smart |
---|---|
Gender | Female |
Speciality | Urology |
Location | 19415 Deerfield Avenue, Suite 112, Leesburg, Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1528520681 | NPI | - | NPPES |
30018093910001 | Medicaid | VA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | 0101279969 (Virginia) | Primary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Entity Name | Loudoun Medical Group, Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1407908817 PECOS PAC ID: 0042119661 Enrollment ID: O20040102000616 |
Mailing Address | Practice Location Address |
---|---|
Amanda Elizabeth Smart, 224-d Cornwall Street Nw, Suite 403, Leesburg, VA 20176-2704 Ph: (703) 737-6010 | Amanda Elizabeth Smart, 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176-8470 Ph: (703) 724-1195 |
Dr. Kyle Matthew Lester, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 | |
Christine Ngoc Bich Tran, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Chuck G Pruna, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Gregory S Schenk, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Kevin Paul O'connor, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Ave Ste 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 | |
Dr. Walter M O'brien, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 19415 Deerfield Avenue, Suite 112, Leesburg, VA 20176 Phone: 703-724-1195 Fax: 703-724-4495 |