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NPI Code Detail

MEDICARE: DR. GEORGE EDMOND SMITH M.D.

MEDICARE: DR. GEORGE EDMOND SMITH M.D.
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
1207Q00000XFamily Medicine PhysicianMD034972EPA

General Provider Information

NPI Number : 1427029479
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. GEORGE EDMOND SMITH M.D.
Provider Business Mailing Address
First Line : 1444 W. PASSYUNK AVE.
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145
Country : US
Telephone Number : 337-244-4220
Fax Number :
Provider Business Practice Location Address
First Line : 1444 W PASSYUNK AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19145-2312
Country : US
Telephone Number : 337-244-4220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2006
Last Update Date : 01/18/2026

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