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NPI Code Detail

MEDICARE: DR. SIDNEY J SMITH M.D.

MEDICARE: DR. SIDNEY J 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
1207V00000XObstetrics & Gynecology Physician01057125MI
2207V00000XObstetrics & Gynecology PhysicianMD-42997IA

General Provider Information

NPI Number : 1447244272
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SIDNEY J SMITH M.D.
Provider Business Mailing Address
First Line : 1201 3RD AVE SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-4009
Country : US
Telephone Number : 319-730-7300
Fax Number : 319-730-7368
Provider Business Practice Location Address
First Line : 1201 3RD AVE SE
Second Line :
City : CEDAR RAPIDS
State : IA
Zip : 52403-4009
Country : US
Telephone Number : 319-730-7300
Fax Number : 319-730-7368
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 10/29/2015

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