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NPI Code Detail

MEDICARE: DR. CARL BERT SMITH D.P.M.

MEDICARE: DR. CARL BERT SMITH D.P.M.
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
1213ES0131XFoot Surgery Podiatrist0031NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2480011132OTHERNVRAILROAD MEDICARE ID #

Other Identifiers

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

General Provider Information

NPI Number : 1255391579
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL BERT SMITH D.P.M.
Provider Business Mailing Address
First Line : 3777 S PECOS MCLEOD
Second Line : SUITE 103
City : LAS VEGAS
State : NV
Zip : 89121-4264
Country : US
Telephone Number : 702-434-2023
Fax Number : 702-434-1976
Provider Business Practice Location Address
First Line : 3777 S PECOS MCLEOD
Second Line : SUITE 103
City : LAS VEGAS
State : NV
Zip : 89121-4264
Country : US
Telephone Number : 702-434-2023
Fax Number : 702-434-1976
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2006
Last Update Date : 11/14/2011

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