Individual
DOUGLAS C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2900 PROVIDENCE DR, ANCHORAGE, AK 99508-5756
(907) 345-0728
(907) 345-0728
Mailing address
PO BOX 241769, ANCHORAGE, AK 99524-1769
(907) 770-2380
(907) 770-2341
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
2227
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
920128597
FEDERAL TAX ID
—
01
—
A0328
BLUE CROSS SUB
—
05
—
MD0658
—
AK
Enumeration date
03/11/2006
Last updated
09/02/2010
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