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NPI Code Detail

MEDICARE: DR. MELISSA SMITH MD

MEDICARE: DR. MELISSA SMITH MD
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
12084P0800XPsychiatry PhysicianM-15361ID
22084P0800XPsychiatry Physician66644GA

General Provider Information

NPI Number : 1750512521
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MELISSA SMITH MD
Provider Business Mailing Address
First Line : 411 CHURCH ST
Second Line :
City : SELMA
State : AL
Zip : 36701-4565
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 824 S DIAMOND ST
Second Line :
City : NAMPA
State : ID
Zip : 83686-5960
Country : US
Telephone Number : 208-606-0396
Fax Number : 208-936-7002
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2009
Last Update Date : 06/12/2026

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Directions to “ DR. MELISSA SMITH MD” Practice Location

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