Individual
BRIAN KEITH SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8324 OSWEGO RD, STE D, LIVERPOOL, NY 13090-1086
(315) 652-6551
(315) 652-7039
Mailing address
8324 OSWEGO RD, STE D, LIVERPOOL, NY 13090-1086
(315) 652-6551
(315) 652-7039
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
173977
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01833178
—
NY
01
—
080178299
RAILROAD MEDICARE
—
01
—
990459
MVP HEALTHCARE
—
Enumeration date
11/30/2006
Last updated
11/08/2018
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