Healthcare Provider Details

I. General information

NPI: 1952309411
Provider Name (Legal Business Name): WILLIAM JAMES SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 OLD MILITARY RD
LAKE PLACID NY
12946-1738
US

IV. Provider business mailing address

203 OLD MILITARY RD
LAKE PLACID NY
12946-1738
US

V. Phone/Fax

Practice location:
  • Phone: 518-523-1327
  • Fax: 518-523-9964
Mailing address:
  • Phone: 518-523-1327
  • Fax: 518-523-9964

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number183901
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: