MEDICARE: DR. WILLIAM EDGAR SMITH JR. MD

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	207X00000X	Orthopaedic Surgery Physician	ME42043	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1114921921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM EDGAR SMITH JR. MD

Provider Business Mailing Address
First Line	:	1823 N 9TH AVE
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-5270
Country	:	US
Telephone Number	:	850-432-3293
Fax Number	:	850-469-9113

Provider Business Practice Location Address
First Line	:	1823 N 9TH AVE
Second Line	:
City	:	PENSACOLA
State	:	FL
Zip	:	32503-5270
Country	:	US
Telephone Number	:	850-432-3293
Fax Number	:	850-469-9113

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	02/24/2020

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