Larry Alan Smith, DPM | |
1041 4th St, Ste B, Santa Rosa, CA 95404 | |
(707) 526-4777 | |
(707) 526-8809 |
Full Name | Larry Alan Smith |
---|---|
Gender | Male |
Speciality | Podiatrist |
Location | 1041 4th St, Santa Rosa, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609979822 | NPI | - | NPPES |
7704019 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
213E00000X | Podiatrist | 000E21510 (California) | Primary |
Provider Name | State Of California - Department Of Developmental Services |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1154372498 PECOS PAC ID: 4082788732 Enrollment ID: O20081114000496 |
Mailing Address | Practice Location Address |
---|---|
Larry Alan Smith, DPM 1041 4th St, Ste B, Santa Rosa, CA 95404 Ph: (707) 526-4777 | Larry Alan Smith, DPM 1041 4th St, Ste B, Santa Rosa, CA 95404 Ph: (707) 526-4777 |
Adelina B. Stateva Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 1041 4th St, Suite B, Santa Rosa, CA 95404 Phone: 707-546-2107 Fax: 707-573-0315 | |
John Dirk Hollander, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 95 Montgomery Dr Ste 114, Santa Rosa, CA 95404 Phone: 707-578-1222 Fax: 707-578-8348 | |
Kevin Grierson, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 2281 Cleveland Ave, Santa Rosa, CA 95403 Phone: 707-544-3337 | |
Northern California Medical Assoc Inc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 4761 Hoen Ave, Santa Rosa, CA 95405 Phone: 707-545-0570 Fax: 707-545-0575 | |
John D Hollander Dpm Inc Podiatrist Medicare: Not Enrolled in Medicare Practice Location: 95 Montgomery Dr Ste 114, Santa Rosa, CA 95404 Phone: 707-578-1222 Fax: 707-578-8348 | |
Ashleigh E Korves, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 1701 4th St Ste 100, Santa Rosa, CA 95404 Phone: 707-578-1222 Fax: 707-578-8348 | |
Sharon M. Wiles, DPM Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 401 Bicentennial Way, Santa Rosa, CA 95403 Phone: 707-571-4000 |