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NPI Code Detail

MEDICARE: DENNIS SMITH PA-C

MEDICARE:   DENNIS  SMITH  PA-C
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
1207R00000XInternal Medicine Physician055-0030446VT

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 : 1508825563
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENNIS SMITH PA-C
Provider Business Mailing Address
First Line : PO BOX 1346
Second Line :
City : WILLISTON
State : VT
Zip : 05495-1346
Country : US
Telephone Number : 802-524-7100
Fax Number : 802-524-7021
Provider Business Practice Location Address
First Line : 12 CHURCH ST
Second Line :
City : SWANTON
State : VT
Zip : 05488-1403
Country : US
Telephone Number : 802-868-3175
Fax Number : 802-868-2923
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2006
Last Update Date : 07/08/2007

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Directions to “ DENNIS SMITH PA-C” Practice Location

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