Healthcare Provider Details

I. General information

NPI: 1366428187
Provider Name (Legal Business Name): CURTIS JAMES SMITH PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 N ARLINGTON AVE SUITE 525
RENO NV
89503-4505
US

IV. Provider business mailing address

645 N ARLINGTON AVE SUITE 525
RENO NV
89503-4505
US

V. Phone/Fax

Practice location:
  • Phone: 775-323-7500
  • Fax: 775-789-9208
Mailing address:
  • Phone: 775-323-7500
  • Fax: 775-789-9208

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA955
License Number StateNV
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number955
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number955
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: