MEDICARE: DR. KARL H.S. 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	207VX0201X	Gynecologic Oncology Physician	ME 54539	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00083697	OTHER	FL	RR CARE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1962495036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KARL H.S. SMITH M.D.

Provider Business Mailing Address
First Line	:	7228 SAN PEDRO RD
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32217-3408
Country	:	US
Telephone Number	:	904-636-0231
Fax Number	:

Provider Business Practice Location Address
First Line	:	655 W 8TH ST
Second Line	:	UNIVERSITY OF FLORIDA CENTER FOR WOMEN
City	:	JACKSONVILLE
State	:	FL
Zip	:	32209-6511
Country	:	US
Telephone Number	:	904-244-5626
Fax Number	:

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

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	09/07/2007

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