MEDICARE: DR. GAIL K SMITH VMD, PHD

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	174M00000X	Veterinarian	BV004121L	PA

General Provider Information

NPI Number	:	1841549755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GAIL K SMITH VMD, PHD

Provider Business Mailing Address
First Line	:	3900 DELANCEY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5052
Country	:	US
Telephone Number	:	215-898-4345
Fax Number	:	610-873-2259

Provider Business Practice Location Address
First Line	:	3900 DELANCEY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-5052
Country	:	US
Telephone Number	:	215-898-4345
Fax Number	:	610-873-2259

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

Provider Enumeration Date	:	09/06/2012
Last Update Date	:	09/06/2012

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