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General NPI Number Information
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NPI Number | 1609019934
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Entity Type | Individual
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Provider Name | NATHAN RYAN SMALLWOOD M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/16/2009
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Last Update Date | 04/12/2021
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Provider Practice Location Address
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Address Line | 425 N HIGHLAND AVE STE 130
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City | SHERMAN
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State | TX
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Zip | 75092-7383
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Country | US
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Telephone | 903-892-9179
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Fax | 903-868-2317
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Provider Business Mailing Address
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Address Line | PO BOX 35629
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City | DALLAS
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State | TX
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Zip | 75235-0629
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Country | US
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Telephone | 214-424-2213
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Fax | 214-231-2159
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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 | Q3108
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 208C00000X
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Taxonomy Name | Colon & Rectal Surgery Physician
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License Number | Q3108
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License Number State | TX
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