MEDICARE: JAMES K. SMITH, MD, PC

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	208200000X	Plastic Surgery Physician	MD028398E	PA

General Provider Information

NPI Number	:	1235421108
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAMES K. SMITH, MD, PC

Provider Business Mailing Address
First Line	:	890 BEAVER GRADE RD
Second Line	:	SUITE1
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2653
Country	:	US
Telephone Number	:	412-262-4202
Fax Number	:	412-262-3511

Provider Business Practice Location Address
First Line	:	890 BEAVER GRADE RD
Second Line	:	SUITE1
City	:	MOON TOWNSHIP
State	:	PA
Zip	:	15108-2653
Country	:	US
Telephone Number	:	412-262-4202
Fax Number	:	412-262-3511

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMES KEVIN SMITH
Credential	:	MD
Telephone Number	:	412-262-4202

Provider Enumeration Date	:	05/10/2011
Last Update Date	:	05/10/2011

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