Healthcare Provider Details

I. General information

NPI: 1215993993
Provider Name (Legal Business Name): RICHARD D SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2006
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 WESTGATE DR
BROCKTON MA
02301-1818
US

IV. Provider business mailing address

901 EASTERN AVE
FALL RIVER MA
02723-2848
US

V. Phone/Fax

Practice location:
  • Phone: 774-704-5501
  • Fax:
Mailing address:
  • Phone: 774-704-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License NumberXS49444486
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number57365
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: