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1336257617

NPI Code Detail

MEDICARE: SCOTT L SMITH MD

MEDICARE: SCOTT L 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	1804361205	UT

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
2	18687	OTHER	UT	PEHP
3	5556	OTHER	UT	DESERET HEALTHCARE TRUST
4	QMXAF01481	OTHER	UT	ALTIUS
5	870293873SM1	OTHER	UT	EMIA
6	107007402101	OTHER	UT	SELECT HEALTH
7	87029387384062B004	OTHER	UT	TRICARE

General Provider Information

NPI Number	:	1336257617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT L SMITH MD

Provider Business Mailing Address
First Line	:	830 N 2000 W
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-4047
Country	:	US
Telephone Number	:	801-756-3511
Fax Number	:	801-443-1164

Provider Business Practice Location Address
First Line	:	830 N 2000 W
Second Line	:
City	:	PLEASANT GROVE
State	:	UT
Zip	:	84062-4047
Country	:	US
Telephone Number	:	801-756-3511
Fax Number	:	801-443-1164

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

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	04/29/2013

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Directions to “ SCOTT L SMITH MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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