MEDICARE: DR. MAURICE CAMP 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
1	207T00000X	Neurological Surgery Physician	4470	MT

General Provider Information

NPI Number	:	1871897736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MAURICE CAMP SMITH MD

Provider Business Mailing Address
First Line	:	7821 N HWY 77
Second Line	:
City	:	LEXINGTON
State	:	TX
Zip	:	78947-9320
Country	:	US
Telephone Number	:	979-255-2662
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 CEMETERY RD
Second Line	:
City	:	PARK CITY
State	:	MT
Zip	:	59063-9429
Country	:	US
Telephone Number	:	979-255-2662
Fax Number	:

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

Provider Enumeration Date	:	01/06/2011
Last Update Date	:	01/06/2011

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