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General NPI Number Information
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NPI Number | 1669573515
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Entity Type | Organization
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Legal Business Name | WILLIAM O SMITH MD
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 2100 EMMANUEL WAY SUITE A
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City | SPRINGFIELD
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State | OH
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Zip | 45502-7218
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Country | US
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Telephone | 937-399-6619
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Fax | 937-399-3958
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Provider Business Mailing Address
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Address Line | 2100 EMMANUEL WAY SUITE A
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City | SPRINGFIELD
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State | OH
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Zip | 45502-7217
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MGR
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Name | MRS. CLAUDIA J BREWER
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Credential |
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Telephone | 937-399-6619
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 35037402S
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License Number State | OH
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