MEDICARE: DR. HENRY THOMAS SMITH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	5592A	WY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	303832	OTHER	WY	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1104822972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HENRY THOMAS SMITH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 8760
Second Line	:
City	:	JACKSON
State	:	WY
Zip	:	83002-8760
Country	:	US
Telephone Number	:	307-733-1122
Fax Number	:	307-734-9577

Provider Business Practice Location Address
First Line	:	230 EAST BROADWAY
Second Line	:
City	:	JACKSON
State	:	WY
Zip	:	83001
Country	:	US
Telephone Number	:	307-733-1122
Fax Number	:	307-734-9577

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/24/2005
Last Update Date	:	07/08/2007

Similar Medicare Providers

1407143100 — MARK MATTHEW NEIMAT M.D.
Practice Location Address:

625 E BROADWAY AVE
JACKSON, WY
83001-8642

Practice Phone: 307-733-3636
Practice Fax: 888-329-5701

1407792211 — KERRY CARR INTEGRATIVE MENTAL HEALTH
Practice Location Address:

480 S CACHE ST
JACKSON, WY
83001-8222

Practice Phone: 307-207-3301
Practice Fax:

1871442566 — TETON CREST COUNSELING LLC
Practice Location Address:

10 PIONEER LN STE 11
JACKSON, WY
83001-8175

Practice Phone: 307-413-8393
Practice Fax:

1790639573 — CALM WATERS PSYCHIATRY, LLC
Practice Location Address:

10 PIONEER LN STE 10
JACKSON, WY
83001-8175

Practice Phone: 775-772-1102
Practice Fax:

1629922497 — THERESE HOOFT DNP, MHS, PMHNP-BC
Practice Location Address:

10 PIONEER LN STE 10
JACKSON, WY
83001-8175

Practice Phone: 775-772-1102
Practice Fax:

1467934216 — COURTNEY H MARVIN LCSW
Practice Location Address:

6505 FORWEAL DR
JACKSON, WY
83001-8875

Practice Phone: 307-690-7067
Practice Fax:

Directions to “ DR. HENRY THOMAS SMITH M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.