MEDICARE: DR. W. KENT SMITH 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	207Q00000X	Family Medicine Physician	9506	NH

General Provider Information

NPI Number	:	1144266594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. W. KENT SMITH MD

Provider Business Mailing Address
First Line	:	4 CRESCENT ST
Second Line	:
City	:	PENACOOK
State	:	NH
Zip	:	03303-1412
Country	:	US
Telephone Number	:	603-753-4302
Fax Number	:	603-753-6213

Provider Business Practice Location Address
First Line	:	4 CRESCENT ST
Second Line	:
City	:	PENACOOK
State	:	NH
Zip	:	03303-1412
Country	:	US
Telephone Number	:	603-753-4302
Fax Number	:	603-753-6213

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

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	11/25/2015

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