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NPI Code Detail

MEDICARE: PHILLIP SMITH ARNP

MEDICARE: PHILLIP SMITH ARNP
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
1363L00000XNurse PractitionerARNP 9422096FL

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 : 1366981177
Entity Type Code : Individual
Provider Name (Legal Business Name) : PHILLIP SMITH ARNP
Provider Business Mailing Address
First Line : 35 PINTAIL BLVD
Second Line :
City : FREEPORT
State : FL
Zip : 32439-3514
Country : US
Telephone Number : 256-283-8793
Fax Number :
Provider Business Practice Location Address
First Line : 281 STATE HIGHWAY 20 E
Second Line :
City : FREEPORT
State : FL
Zip : 32439-3929
Country : US
Telephone Number : 850-835-1235
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2017
Last Update Date : 02/14/2017

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Directions to “ PHILLIP SMITH ARNP” Practice Location

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