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NPI Code Detail

MEDICARE: DR. AARON DOUGLAS SMITH M.D.

MEDICARE: DR. AARON DOUGLAS 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
1208600000XSurgery Physician76938AZ
22086S0122XPlastic and Reconstructive Surgery Physician103757MN
32086S0122XPlastic and Reconstructive Surgery Physician48708CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417159625
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AARON DOUGLAS SMITH M.D.
Provider Business Mailing Address
First Line : 5901 CORPORATE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1941
Country : US
Telephone Number : 520-370-7660
Fax Number :
Provider Business Practice Location Address
First Line : 5901 CORPORATE DR
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80919-1941
Country : US
Telephone Number : 520-370-7660
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2007
Last Update Date : 08/24/2012

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