MEDICARE: DR. JAMES W SMITH D.O.

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	OS4702	FL
2	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician	OS4702	FL

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

General Provider Information

NPI Number	:	1366417719
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES W SMITH D.O.

Provider Business Mailing Address
First Line	:	5300 EAST AVE
Second Line	:
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33407-2387
Country	:	US
Telephone Number	:	561-227-5270
Fax Number	:	561-863-2806

Provider Business Practice Location Address
First Line	:	6635 FOREST HILL BLVD
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33413-3354
Country	:	US
Telephone Number	:	561-969-3808
Fax Number	:	561-969-0032

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	02/13/2017

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