MEDICARE: DR. MARK WALKER SMITH M.D.

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	174400000X	Specialist	22634	AL

General Provider Information

NPI Number	:	1396715843
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK WALKER SMITH M.D.

Provider Business Mailing Address
First Line	:	1015 S JACKSON HWY
Second Line	:
City	:	SHEFFIELD
State	:	AL
Zip	:	35660-5760
Country	:	US
Telephone Number	:	256-381-5510
Fax Number	:	256-386-5551

Provider Business Practice Location Address
First Line	:	1015 S JACKSON HWY
Second Line	:
City	:	SHEFFIELD
State	:	AL
Zip	:	35660-5760
Country	:	US
Telephone Number	:	256-381-5510
Fax Number	:	256-386-5551

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	07/08/2007

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