Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS4702 | FL |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | OS4702 | FL |
NPI | 1366417719 |
---|---|
Provider Name | Dr. James W Smith |
First Address | West Palm Beach, FL 33407-2387 |
Second Address | Greenacres, FL 33413-3354 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2006 |
Last Update Date | 13/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
006745100 | (05) | FL |
E46043 | (02) | FL |