MEDICARE: DR. ARNOLD GRAHAM SMITH MD

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	207XS0117X	Orthopaedic Surgery of the Spine Physician	ME0039103	FL

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	010001690	OTHER	FL	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	15651	OTHER	FL	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1194805085
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARNOLD GRAHAM SMITH MD

Provider Business Mailing Address
First Line	:	9191 R G SKINNER PKWY
Second Line	:	SUITE 103
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-9655
Country	:	US
Telephone Number	:	904-391-6862
Fax Number	:	904-391-1005

Provider Business Practice Location Address
First Line	:	9191 R G SKINNER PKWY
Second Line	:	SUITE 103
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-9655
Country	:	US
Telephone Number	:	904-391-6862
Fax Number	:	904-391-1005

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

Provider Enumeration Date	:	10/16/2006
Last Update Date	:	07/12/2013

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Directions to “ DR. ARNOLD GRAHAM SMITH MD” Practice Location

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