Healthcare Provider Details

I. General information

NPI: 1669545968
Provider Name (Legal Business Name): CURTIS A. SMITH, D.O.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2006
Last Update Date: 05/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 S CENTRAL AVE
LAUREL DE
19956-1525
US

IV. Provider business mailing address

314 S CENTRAL AVE
LAUREL DE
19956-1525
US

V. Phone/Fax

Practice location:
  • Phone: 302-875-6800
  • Fax: 302-875-6803
Mailing address:
  • Phone: 302-875-6800
  • Fax: 302-875-6803

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC20003304
License Number StateDE

VIII. Authorized Official

Name: DR. CURTIS A SMITH
Title or Position: OWNER
Credential: D.O.
Phone: 302-875-6800