Individual
DR. BENNETT WALKER SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9651 MAYPAN PL, LARGO, FL 33777-4906
(727) 397-4795
Mailing address
9651 MAYPAN PL, LARGO, FL 33777-4906
(727) 397-4795
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
ME88402
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
268375000
—
FL
01
—
81922
FL BCBS
FL
01
—
81922V
FL MEDICARE
FL
01
—
P00087439
MEDICARE RAILROAD
FL
Enumeration date
05/23/2006
Last updated
05/29/2009
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