MEDICARE: PAUL G SMITH D.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
1	111N00000X	Chiropractor	B175	NV

General Provider Information

NPI Number	:	1548495625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAUL G SMITH D.C.

Provider Business Mailing Address
First Line	:	8785 W WARM SPRINGS RD.
Second Line	:	SUITE 109
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1623
Country	:	US
Telephone Number	:	702-731-1200
Fax Number	:	702-736-6302

Provider Business Practice Location Address
First Line	:	8785 W WARM SPRINGS ROAD
Second Line	:	SUITE 109
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-1823
Country	:	US
Telephone Number	:	702-731-1200
Fax Number	:	702-736-6302

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

Provider Enumeration Date	:	05/19/2009
Last Update Date	:	05/19/2009

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