Individual
DR. ARCHIE DAN SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1215 RED RIVER, AUSTIN, TX 78701-1921
(512) 479-3526
(512) 474-2720
Mailing address
PO BOX 5692, AUSTIN, TX 78763-5692
(512) 474-5244
(512) 474-5244
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
E8916
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000B56J
BLUE CROSS
—
01
—
E8916
COMMERCIAL - LICENSE
—
Enumeration date
02/13/2007
Last updated
10/10/2007
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