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NPI Code Detail

MEDICARE: PERCY SMITH

MEDICARE:   PERCY  SMITH
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1497647655
Entity Type Code : Individual
Provider Name (Legal Business Name) : PERCY SMITH
Provider Business Mailing Address
First Line : 3910 ELATI ST APT 533
Second Line :
City : DENVER
State : CO
Zip : 80216-5156
Country : US
Telephone Number : 970-394-0330
Fax Number :
Provider Business Practice Location Address
First Line : 3539 DOUGLAS DR N
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55422-2415
Country : US
Telephone Number : 612-642-1355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2025
Last Update Date : 07/21/2025

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Directions to “ PERCY SMITH ” Practice Location

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