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NPI Code Detail

MEDICARE: NATHAINA FELICIA SMITH D.O.

MEDICARE: NATHAINA FELICIA SMITH D.O.
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 PhysicianOS020763PA
2207Q00000XFamily Medicine PhysicianDO2971NV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2DO2971OTHERNVSTATE LICENSE

General Provider Information

NPI Number : 1710411400
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAINA FELICIA SMITH D.O.
Provider Business Mailing Address
First Line : 6355 S BUFFALO DR FL 3
Second Line :
City : LAS VEGAS
State : NV
Zip : 89113-2133
Country : US
Telephone Number : 702-216-3346
Fax Number : 702-671-6883
Provider Business Practice Location Address
First Line : 1302 W CRAIG RD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-0246
Country : US
Telephone Number : 702-657-9555
Fax Number : 702-657-9040
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2017
Last Update Date : 10/13/2022

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Directions to “ NATHAINA FELICIA SMITH D.O.” Practice Location

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