MEDICARE: DR. DEBORAH LEE SMITH-WRIGHT 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	208000000X	Pediatrics Physician	29657	MN

General Provider Information

NPI Number	:	1295806693
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEBORAH LEE SMITH-WRIGHT MD

Provider Business Mailing Address
First Line	:	P.O. BOX 209036
Second Line	:	SHRINERS HOSPITALS FOR CHILDREN @ TWIN CITIES
City	:	DALLAS
State	:	TX
Zip	:	75320-9036
Country	:	US
Telephone Number	:	813-281-8478
Fax Number	:	813-281-8113

Provider Business Practice Location Address
First Line	:	2025 E RIVER PKWY
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55414-3604
Country	:	US
Telephone Number	:	612-596-6187
Fax Number	:	612-339-7634

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

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	03/28/2011

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