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General NPI Number Information
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NPI Number | 1134682453
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Entity Type | Individual
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Provider Name | DR. ANDREW CLARK SMITH
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Gender | Male
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 1329 SW 16TH ST
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City | GAINESVILLE
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State | FL
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Zip | 32608-1128
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Country | US
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Telephone | 352-733-1471
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 100186
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City | GAINESVILLE
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State | FL
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Zip | 32610-0186
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Country | US
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Telephone | 352-273-5422
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 156201
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | 103684
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207PS0010X
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Taxonomy Name | Sports Medicine (Emergency Medicine) Physician
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License Number | 156201
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 156201
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number | 103684
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License Number State | GA
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