Healthcare Provider Details

I. General information

NPI: 1770406704
Provider Name (Legal Business Name): DAVID M SMITH MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 5TH AVE
LONGMONT CO
80501-5327
US

IV. Provider business mailing address

1121 5TH AVE
LONGMONT CO
80501-5327
US

V. Phone/Fax

Practice location:
  • Phone: 216-544-8451
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID MATHIAS SMITH
Title or Position: OWNER
Credential: MD
Phone: 216-544-8451