MEDICARE: DR. PATRICK M SMITH DC

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	CH8799	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	64020	OTHER	FL	BC/BS

General Provider Information

NPI Number	:	1083795942
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PATRICK M SMITH DC

Provider Business Mailing Address
First Line	:	2447 MILL CREEK CT
Second Line	:	SUITE 1
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8300
Country	:	US
Telephone Number	:	850-325-6468
Fax Number	:

Provider Business Practice Location Address
First Line	:	2447 MILL CREEK CT
Second Line	:	SUITE 1
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-8300
Country	:	US
Telephone Number	:	850-325-6468
Fax Number	:

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

Provider Enumeration Date	:	10/18/2006
Last Update Date	:	03/16/2017

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Directions to “ DR. PATRICK M SMITH DC” Practice Location

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