MEDICARE: DR. RICHARD B SMITH III 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
1	207Y00000X	Otolaryngology Physician	042-0010128	VT
2	207Y00000X	Otolaryngology Physician	17443	NH

General Provider Information

NPI Number	:	1689674426
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD B SMITH III M.D.

Provider Business Mailing Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:	DARTMOUTH HITCHCOCK - OTOLARYNGOLOGY
City	:	LEBANON
State	:	NH
Zip	:	03756-1000
Country	:	US
Telephone Number	:	603-650-9762
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MEDICAL CENTER DR
Second Line	:	DARTMOUTH HITCHCOCK - OTOLARYNGOLOGY
City	:	LEBANON
State	:	NH
Zip	:	03756-1000
Country	:	US
Telephone Number	:	603-650-9762
Fax Number	:

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

Provider Enumeration Date	:	07/22/2005
Last Update Date	:	07/29/2016

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