MEDICARE: DR. HUGH SANFORD SMITH PH.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	103TC0700X	Clinical Psychologist	PS-008355-L	PA

Other Identifiers

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

General Provider Information

NPI Number	:	1780706069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HUGH SANFORD SMITH PH.D.

Provider Business Mailing Address
First Line	:	1834 OREGON PIKE
Second Line	:	SUITE 4
City	:	LANCASTER
State	:	PA
Zip	:	17601-6463
Country	:	US
Telephone Number	:	717-391-6808
Fax Number	:	717-391-0709

Provider Business Practice Location Address
First Line	:	1834 OREGON PIKE
Second Line	:	SUITE 4
City	:	LANCASTER
State	:	PA
Zip	:	17601-6463
Country	:	US
Telephone Number	:	717-391-6808
Fax Number	:	717-391-0709

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

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	06/12/2016

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