| Doctor Name: | MR. PHILIP ALLEN SMITH |
| NPI Number: | 1205023769 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A.-C |
| License Number: | 007448 |
| Business Practice Address: | 1 Air National Guard Rd Scotia, NY - 12302 |
| Business Phone Number: | 5183443402 |
| Business Fax Number: | 5183443428 |
| Mailing Address: | 1 Air National Guard Rd Bldg 43, SCOTIA |
| State: | NY |
| Postal Code: | 123029752 |
| Phone Number: | 5183443402 |
| Fax Number: | 5153443428 |
| NPI Enumeration Date: | 09/28/2007 |
| NPI Last Update Date: | 02/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 007448 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |