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General NPI Number Information
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NPI Number | 1760556765
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Entity Type | Individual
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Provider Name | EDWARD PATRICK SMITH JR. DPM PODIATRY
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Gender | Male
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Dates
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Enumeration Date | 11/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 148 PARK STREET
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City | SPRINGFIELD
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State | VT
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Zip | 05156
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Country | US
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Telephone | 802-885-2318
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Fax | 802-885-3950
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Provider Business Mailing Address
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Address Line | 148 PARK STREET
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City | SPRINGFIELD
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State | VT
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Zip | 05156
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Country | US
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Telephone | 802-885-2318
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Fax | 802-885-3950
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | VT0560000101
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License Number State | VT
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | NH0277
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | MA1543
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License Number State | MA
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