Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 5451 | NV |
N | 111NI0900X | Internist | 5451 | NV |
N | 207RC0200X | Critical Care Medicine | 5451 | NV |
Y | 207RP1001X | Pulmonary Disease | 5451 | NV |
NPI | 1073596722 |
---|---|
Provider Name | Dr. Leslie Scott Smith |
First Address | Reno, NV 89502-1576 |
Second Address | Reno, NV 89502-1198 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/11/2005 |
Last Update Date | 16/12/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1073596722 | (05) | NV |
C96578 | (02) |