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Individual

DR. MARK KEITH SMITH

Active
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Individual

DR. MARK KEITH SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G8976
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255309-04
—
TX
01
—
16167-0010
PACIFICARE
—
01
—
2044061
AETNA
—
01
—
2322005
BLUELINK
—
01
—
2929822005
CIGNA HMO
—
01
—
2929872004
CIGNA POS
—
01
—
737803
HUMANA GOLD
—
01
—
85276Y
BCBS
—
01
—
873571
ONE HEALTH
—
Enumeration date
07/01/2005
Last updated
11/01/2011
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