Organization Name: | TIM M SMITH, M.D. |
NPI Number: | 1356519128 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TIM M SMITH (OWNER) |
Mailing Address: | 100 Doctors Dr Panama City |
State: | FL US |
Postal Code: | 324057608 |
Phone Number: | 8507633722 |
Fax Number: | 8507857393 |
NPI Enumeration Date: | 02/14/2008 |
NPI Last Update Date: | 02/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME8816 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |