Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 105721 | CO |
Y | 213EG0000X | General Practice | 105721 | CO |
NPI | 1003905035 |
---|---|
Provider Name | Dr. Richard Lee Smith |
First Address | Lakewood, CO 80226-2576 |
Second Address | Lakewood, CO 80226-2576 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 02/04/2014 |