Charlie D Smith III
Cardiothoracic Vascular Surgeon
2322 Burnt Branch Rd
Lake City
, South Carolina 29560-7910
Charlie D Smith III
Cardiothoracic Vascular Surgeon
2322 Burnt Branch Rd
Lake City
, South Carolina 29560-7910
(843) 673-9457
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About
Features
Specialties
- Cardiothoracic Vascular Surgeon
Languages spoken
- English
Location
First Address
- Charlie D Smith III
- Po Box 266
- Olanta, SC
- Zip : 29114-0266
- Fax : (843) 673-9457
- Phone : (843) 687-0153
Second Address
- Charlie D Smith III
- 2322 Burnt Branch Rd
- Lake City, SC
- Zip : 29560-7910
- Fax : (843) 673-9457
- Phone : (843) 687-0153
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208G00000X | Cardiothoracic Vascular Surgeon | 13042 | SC |
National Provider Identifier
| NPI | 1003874892 |
|---|---|
| Provider Name | Charlie D Smith III |
| First Address | Olanta, SC 29114-0266 |
| Second Address | Lake City, SC 29560-7910 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 02/05/2006 |
| Last Update Date | 23/10/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 130423 | (05) | SC |
| 1679530968 | GROUP NPI (01) | SC |
| 7937 | MEDICARE GROUP NUMBER (01) | SC |
| F36980 | (02) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.