| Doctor Name: | DR. MARC LLOYD SMITH |
| NPI Number: | 1427133446 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 55305525818307 |
| Business Practice Address: | 11803 W North Ave Wauwatosa, WI - 53226 |
| Business Phone Number: | 4142585522 |
| Business Fax Number: | 4142581337 |
| Mailing Address: | 11803 W North Ave, WAUWATOSA |
| State: | WI |
| Postal Code: | 53226 |
| Phone Number: | 4142585522 |
| Fax Number: | 4142581337 |
| NPI Enumeration Date: | 10/26/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 55305525818307 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |