Provider Demographics
NPI:1699304428
Name:HORNERSMITH, COREY ALEXANDER (MD)
Entity type:Individual
Prefix:DR
First Name:COREY
Middle Name:ALEXANDER
Last Name:HORNERSMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:COREY
Other - Middle Name:ALEXANDER
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:830 KEMPSVILLE RD FL 1
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3920
Mailing Address - Country:US
Mailing Address - Phone:757-261-8070
Mailing Address - Fax:
Practice Address - Street 1:830 KEMPSVILLE RD FL 1
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502-3920
Practice Address - Country:US
Practice Address - Phone:757-261-8070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-03
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101279649208M00000X
VA0116034549207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty