MEDICARE: DR. TANA R SMITH M.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	207Q00000X	Family Medicine Physician	41187	CO

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	:	1932161114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANA R SMITH M.D.

Provider Business Mailing Address
First Line	:	1707 COLE BLVD STE 100
Second Line	:
City	:	GOLDEN
State	:	CO
Zip	:	80401-3219
Country	:	US
Telephone Number	:	303-763-4900
Fax Number	:	303-763-5495

Provider Business Practice Location Address
First Line	:	13402 W COAL MINE AVE STE 300
Second Line	:
City	:	LITTLETON
State	:	CO
Zip	:	80127-5407
Country	:	US
Telephone Number	:	303-963-0566
Fax Number	:

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

Provider Enumeration Date	:	04/04/2006
Last Update Date	:	02/13/2024

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