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NPI Code Detail

MEDICARE: DENNIS W SMITH D.P.M.

MEDICARE: DENNIS W SMITH D.P.M.
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
1213EP1101XPrimary Podiatric Medicine Podiatrist07000765IN
2213ES0000XSports Medicine Podiatrist07000765IN
3213ES0103XFoot & Ankle Surgery Podiatrist07000765IN

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 : 1477546265
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS W SMITH D.P.M.
Provider Business Mailing Address
First Line : 1275 E NORTH ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-3538
Country : US
Telephone Number : 219-663-9446
Fax Number : 219-663-9450
Provider Business Practice Location Address
First Line : 1275 E NORTH ST
Second Line :
City : CROWN POINT
State : IN
Zip : 46307-3538
Country : US
Telephone Number : 219-663-9446
Fax Number : 219-663-9450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/26/2005
Last Update Date : 03/10/2020

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