MEDICARE: DR. BENJAMIN DREW SMITH D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	9332	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8P9670	OTHER	TX	BCBS PROVIDER
2	00150X	OTHER	TX	GROUP

General Provider Information

NPI Number	:	1053322487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BENJAMIN DREW SMITH D.C.

Provider Business Mailing Address
First Line	:	3717 VERDE DR
Second Line	:
City	:	KELLER
State	:	TX
Zip	:	76248-8189
Country	:	US
Telephone Number	:	682-831-0598
Fax Number	:

Provider Business Practice Location Address
First Line	:	4851 S INTERSTATE 35 E
Second Line	:	SUITE 202
City	:	CORINTH
State	:	TX
Zip	:	76210-2348
Country	:	US
Telephone Number	:	940-270-2222
Fax Number	:	940-269-2223

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. BENJAMIN DREW SMITH D.C.” Practice Location

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