MEDICARE: DR. WILLIAM D SMITH M.D.

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	7897	NV
2	207T00000X	Neurological Surgery Physician	22506	AZ

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	140004333	OTHER	NV	RAILROAD MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1578520532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM D SMITH M.D.

Provider Business Mailing Address
First Line	:	3061 S MARYLAND PKWY
Second Line	:	SUITE 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2298
Country	:	US
Telephone Number	:	702-737-1948
Fax Number	:	702-737-7195

Provider Business Practice Location Address
First Line	:	3061 S MARYLAND PKWY
Second Line	:	SUITE 200
City	:	LAS VEGAS
State	:	NV
Zip	:	89109-2298
Country	:	US
Telephone Number	:	702-737-1948
Fax Number	:	702-737-7195

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

Provider Enumeration Date	:	04/26/2006
Last Update Date	:	08/02/2013

3061 S MARYLAND PKWY , SUITE 202
LAS VEGAS, NV
89109-2298

Practice Phone: 702-731-0022
Practice Fax: 702-731-0292

3061 S MARYLAND PKWY , SUITE 103
LAS VEGAS, NV
89109-2298

Practice Phone: 702-992-1200
Practice Fax: 702-992-1205

3061 S MARYLAND PKWY , SUITE 102
LAS VEGAS, NV
89109-2298