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Individual

WILLIAM THOMAS SMITH IV

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9205 SW BARNES RD, PORTLAND, OR 97225-6603
(503) 216-1234
Mailing address
9155 SW BARNES RD, SUITE 420, PORTLAND, OR 97225-6625
(503) 297-6334

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD166773
OR
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/19/2011
Last updated
07/29/2014
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