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General NPI Number Information
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NPI Number | 1477873065
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Entity Type | Individual
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Provider Name | LACHLAN MCGALLIARD SMITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/04/2010
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Last Update Date | 04/26/2022
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Provider Practice Location Address
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Address Line | 101 NICOLLS RD
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City | STONY BROOK
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State | NY
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Zip | 11794-1675
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Country | US
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Telephone | 631-444-7955
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1599
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City | STONY BROOK
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State | NY
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Zip | 11790-0894
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Country | US
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Telephone | 631-444-7955
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 48620
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | TP495
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License Number State | KY
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 53158
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 304602
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License Number State | NY
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