Healthcare Provider Details
I. General information
NPI: 1386283158
Provider Name (Legal Business Name): SMITH PSYCHIATRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/27/2019
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6940 SIERRA CENTER PKWY
RENO NV
89511-2209
US
IV. Provider business mailing address
PO BOX 18565
RENO NV
89511-0565
US
V. Phone/Fax
- Phone: 775-393-2000
- Fax: 775-851-1456
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
WALTER
DAVID
SMITH
Title or Position: OWNER / PHYSICIAN
Credential: MD
Phone: 775-378-6992