MEDICARE: JANET L SMALLEY 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
1	207P00000X	Emergency Medicine Physician	1876	AK

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	:	1811984867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JANET L SMALLEY MD

Provider Business Mailing Address
First Line	:	16750 E HUNTLEY RD
Second Line	:
City	:	PALMER
State	:	AK
Zip	:	99645
Country	:	US
Telephone Number	:	907-982-3012
Fax Number	:

Provider Business Practice Location Address
First Line	:	16750 E HUNTLEY RD
Second Line	:
City	:	PALMER
State	:	AK
Zip	:	99645-8718
Country	:	US
Telephone Number	:	907-982-3012
Fax Number	:

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

Provider Enumeration Date	:	10/04/2005
Last Update Date	:	08/08/2012

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