Doctor Name: | DOUGLAS C SMITH |
NPI Number: | 1285602508 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 2227 |
Business Practice Address: | 2900 Providence Dr Anchorage, AK - 995085756 |
Business Phone Number: | 9073450728 |
Business Fax Number: | 9073450728 |
Mailing Address: | Po Box 241769, ANCHORAGE |
State: | AK |
Postal Code: | 995241769 |
Phone Number: | 9077702380 |
Fax Number: | 9077702341 |
NPI Enumeration Date: | 03/11/2006 |
NPI Last Update Date: | 09/02/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 2227 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |