Douglas Carter Smith, Md | |
17741 Mountainside Village Dr Anchorage AK 99516-5756 | |
(907) 345-0728 | |
(907) 345-0728 |
Full Name | Douglas Carter Smith, Md |
---|---|
Speciality | Family Medicine |
Location | 17741 Mountainside Village Dr, Anchorage, Alaska |
Authorized Official Name and Position | Joseph E Beaty (BILLING AGENT) |
Authorized Official Contact | 9077702301 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Douglas Carter Smith, Md Po Box 241769 Anchorage AK 99524-1769 Ph: (907) 770-2380 | Douglas Carter Smith, Md 17741 Mountainside Village Dr Anchorage AK 99516-5756 Ph: (907) 345-0728 |
NPI Number | 1023169109 |
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Provider Enumeration Date | 01/15/2007 |
Last Update Date | 04/01/2020 |
Medicare PECOS PAC ID | 1759718760 |
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Medicare Enrollment ID | O20200303001043 |
Identifier | Type | State | Issuer |
---|---|---|---|
1023169109 | NPI | - | NPPES |
MGD157 | Medicaid | AK |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 112749 (Alaska) | Primary |
Provider Name | Douglas C Smith |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1285602508 PECOS PAC ID: 6002706561 Enrollment ID: I20040318000057 |
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